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Research

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Living Positive

Living Positive: Designing Tailored Stress Management Interventions for People Living with Human Immunodeficiency Virus (HIV) in Rural Virginia and Assessing Results with Cutting-edge Biomarkers and Mobile Technologies

These researchers sought to understand and address the effects of stress on people living with HIV in the rural South. Although there have been significant advances in the treatment and management of HIV, many people living with HIV still face significant barriers to well-being and longevity. One of these barriers is a constellation of stressors experienced by people living with HIV. While it is known that stress (particularly traumatic stress) translates into worse clinical outcomes, including worse engagement in HIV care, faster progression to AIDS, and AIDS-related mortality, the precise mechanisms by which stress undermines health and well-being are not adequately understood. This is a critical research gap that this study is beginning to address. There are two components to this research: first, an effort to elucidate the biologic mechanisms (with a particular emphasis on aging) through which stress produces poor health outcomes; and second, the development and rigorous evaluation of a meditation-derived practice that is supported by mobile technology. The CSC’s support was channeled to the second component, which interfaced with the Contemplative University’s digital library. Global efforts to ensure treatment and curb the effects of HIV have led to the development of mobile phone assessment and intervention tools that effectively reinforce consistent self-care among people living with HIV in rural or otherwise difficult to access regions. This work was part of a preliminary phase designed to prepare the way for a large-scale clinical trial of the tailored mobile phone-based intervention. The larger trial will bring together the two research threads by measuring, in a single trial, the psychological responses to the tailored intervention as well as key biomarkers related to stress and aging, allowing for new understandings of their inter-relatedness.

Key People: Rebecca Dillingham, Director, Center for Global Health and Assistant Professor of Medicine and Public Health Sciences, University of Virginia; Karen Ingersoll, Associate Professor, Department of Psychiatry and Neurobehavioral Sciences; Katherine Schafer, Postdoctoral Fellow; Elizabeth Blackburn, University of California, San Francisco; Jie Lin, University of California, San Francisco.