A person's socioeconomic position plays a role in the effectiveness of antiretroviral drug treatments for people with HIV, finds a study in the August Journal of Psychosomatic Research(Vol. 63, No. 2).

Study author and Yale public health researcher Linda Marc examined the effectiveness of highly active antiretroviral treatment (HAART) on approximately 1,000 men and women diagnosed with HIV-1, the most common and virulent strain of the virus. HAART is designed to reduce HIV levels in the bloodstream.

Marc says that a lower socioeconomic position is correlated with increased stress and puts a heavier load on the endocrine system—two factors that appear to influence immune functioning. The literature suggests that stress and emotional distress harm immune system cells that fight HIV, which would help explain why people lower on the socioeconomic ladder experienced a shorter time to the first regimen failure, even when they adhered to their medications.

The good news is that when low socioeconomic status people with HIV possessed skills to cope with their condition—known as "adherence self-efficacy"—the regimen failure rate was reduced by up to 17 percent. Marc says that by teaching people with HIV to have confidence in their treatments, to believe in their effectiveness and to be knowledgeable about how the drugs work, therapists can increase the effectiveness of HAART.

—M. Price