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3. The goal is to stay as healthy as possible as long as possible

4. Viral Load CD4+ T-Cell Count H ow do we measure health status in HIV positive people ? 1 = speed of train = track remaining

5. Finding out you are HIV positive is stressful 7

6. more rapid HIV progression ? Is depression associated with be depressed Lyketsos, JAMA, 1993 were more likely to Men with more symptoms 38% greater loss Burack, JAMA, 1993 of CD4+ T-cells/year

7. AIDS P rogression to AIDS and Stressful Stressful Life Events. 8

8. Is there a ? basis biological

9. “Slow HIV progression is CCR5 receptor density. ” correlated with low 10 “ norepinephrine enhanced replication of both CCR5 in vitro via chemokine receptor up-regulation and enhanced viral gene expression” 3

10. by stress, “ To the extent that one’s medical condition and/or symptoms are caused or made worse we can help. ” Herbert Benson, MD Benson-Henry Institute for Mind-Body Medicine

11. M ost frequently used alternative and complementary therapies 5

12. Non-exercise control showed significant increases in anxiety and depression as well as decreases in their NK cell count 5

13. exercise treatment group Those in the exercise treatment group showed no similar changes and showed a significant increase in CD4+ Lymphocyte levels. 5

14. Prayer has been clinically examined in an HIV-negative cohort with regard to self- esteem, anxiety, depression and showed significant improvement in 11 outcome measures. (O’Laire, 1997) The majority HIV+ participants increase their practice of prayer since their HIV diagnosis. 5

15. Massage boosts immune system function by : Reducing anxiety and stress Increasing white blood cell counts Decreasing levels of cortisol Activating natural killer cells

16. Reframing challenges may not change reality, but it can change attitude.