The roles of dispositional optimism and pessimism in hiv disease progression

Relationships between dispositional optimism and pessimism and the course of HIV infection, determined by changes in viral load and CD4 counts, were studied in a longitudinal cohort of 412 patients on antiretroviral therapy (ART). Multiple regression analyses controlling for baseline levels of disease status, ethnicity, and depressive symptoms demonstrated that higher pessimism at baseline was associated with higher viral load at follow-up (average of 18 months later). Optimism at baseline had a curvilinear relationship with CD4 counts at follow-up. Moderate levels of optimism at baseline predicted the highest CD4 counts at follow-up. Although optimism and pessimism were associated with specific health behaviors (e.g., ART adherence, cigarette use, drug use, dietary practices), none of these behaviors mediated the optimism/pessimism effects. The biologic and behavioral mediators of associations of personality variables with the course of treated HIV infection deserve continued investigation.