Positive affect promotes engagement in care after HIV diagnosis

Adam W. Carrico, Judith Tedlie Moskowitz*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Objective: Revised Stress and Coping Theory proposes that positive affect serves adaptive functions, and its beneficial effects are heightened during stressful periods. This study examined the prospective relationship between positive affect and engagement in care during the 18 months after a HIV seropositive diagnosis. Methods: The Coping, HIV, and Affect Interview (CHAI) cohort study enrolled 153 individuals who had recently received a HIV seropositive diagnosis. Using logistic and linear regression, baseline positive affect was examined as a predictor of linkage to HIV care, antiretroviral therapy (ART) persistence (i.e., starting ART and remaining on it during subsequent follow-up assessments), and mean log10 HIV viral load over follow-up. Results: After controlling for education, T-helper (CD4+) count, HIV viral load, and negative affect, higher baseline positive affect independently predicted increased odds of linkage to HIV care at 3 months postdiagnosis (adjusted OR [AOR] = 1.10; 95% CI = 1.01-1.21) and ART persistence over the 18-month follow-up period (AOR = 1.08; 95% CI = 1.01-1.16). Positive affect was not directly associated with lower mean HIV viral load over follow-up. However, one standard deviation higher positive affect indirectly predicted 6.7% lower HIV viral load via greater odds of ART persistence (ßindirect =-0.18, p < .05). Conclusions: Greater positive affect predicts linkage to HIV care and ART persistence. ART persistence, in turn, is associated with lower HIV viral load. Clinical research is needed to examine whether interventions designed to enhance positive affect can boost the effectiveness of HIV treatment as prevention.

Original languageEnglish (US)
Pages (from-to)686-689
Number of pages4
JournalHealth Psychology
Issue number7
StatePublished - Jul 2014


  • AIDS
  • Adherence
  • HIV
  • Positive affect
  • Resilience
  • Treatment as prevention

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology


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