Correlates of psychiatric distress among wives of hemophilic men with and without HIV infection

OBJECTIVE: The authors' objectives were 1) to examine symptoms of depression, anxiety, and anger-hostility among the wives of men with hemophilia, a major risk group for AIDS, and 2) to identify psychosocial characteristics of the women and/or their husbands that were associated with elevated distress in the women. METHOD: Thirty-six women married to men with hemophilia were studied; the husbands of 17 of these women were HIV-seropositive. The men were drawn from the population of adults with hemophilia residing in a 24-county region of western Pennsylvania. Measures of wives' psychiatric symptoms were obtained, as were measures in three psychosocial domains: predispositional sociodemographic characteristics, psychosocial stressors, and husbands' strategies for coping. RESULTS: The psychiatric symptoms of the women did not differ as a function of their husbands' serostatus or across subgroups defined according to stages of HIV infection or clinical severity of hemophilia. Instead, other factors--perceptions of personal risk of AIDS, husbands' use of particular coping styles with respect to HIV infection, and the experience of other life events--were the principal correlates of psychiatric distress. CONCLUSIONS: HIV infection acted primarily as an indirect source of stress for these women, mediated by other psychosocial characteristics of both the women and their HIV- seropositive husbands. Mental health interventions for caregivers of HIV-seropositive individuals should target the identified psychosocial correlates of psychiatric distress.