Positive Emotions Suppress HIV Load, Reduce Antidepressant Use


Positivity interventions may influence health outcomes in people living with HIV.

Although some patients may feel a sense of relief after receiving a diagnosis that took months to pinpoint, often, many individuals experience a variety of negative emotions. However, a positive outlook on life may have beneficial effects on overall quality of life.

In a study published in the Journal of Consulting and Clinical Psychology, individuals recently diagnosed with HIV who were taught skills to achieve positive emotions were found to have less HIV in their blood and lower use of antidepressants.

“Even in the midst of this stressful experience of testing positive for HIV, coaching people to feel happy, calm, and satisfied­­­­­­—–what we call positive affect––appears to influence important health outcomes,” said lead author Judith Moskowitz.

Included in the study were 80 HIV-positive patients who were primarily men. The participants were taught a set of 8 skills over 5 weekly sessions to help them experience more positive emotions. There were 79 participants who served as the control group.

The tools were designed based on evidence indicating that the skills increased positive emotions.

The following skills included:

  • Recognizing a positive event each day.
  • Savoring that positive event and recording it in a journal or telling another person.
  • Starting a daily gratitude journal.
  • Listing a personal strength each day and noting how the strength was recently used.
  • Setting an attainable goal each day and noting any progress.
  • Reporting a relatively minor stressor each day, then listing ways in which the event can be positively reappraised.
  • Understanding small acts of kindness, which can have a significant impact on positive emotion, and practicing a small act of kindness each day.
  • Practicing mindfulness with a daily 10-minute breathing exercise that concentrates on breath.

After 15 months of interventions, the results of the study showed that 91% of patients in the intervention group had a suppressed viral load compared with 76% of patients in the control group.

“From a public health perspective, that is potentially huge for prevention of HIV,” Moskowitz said. “HIV is less likely to be transmitted with a low viral load. To have a difference like that is amazing.”

Prior observational studies of individuals with HIV have shown that positive emotion is related to a higher CD4 count.

The authors noted that the reduced viral load may be due to a patient’s stronger immune system, or the result of participants’ better adherence to antiretroviral therapy.

Additionally, the findings showed that positive emotion intervention improved mental health. At baseline, approximately 17% of patients in the control and intervention group reported being on antidepressants. After 15-months, the intervention arm remained at 17%, but antidepressant use in the control arm rose to 35%.

The intervention group was also significantly less likely to have repeating, intrusive thoughts about HIV.

“The group that learned coping skills did not increase antidepressant use, whereas overall, the control group increased its antidepressant use,” Moskowitz said.

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