Abstract
Ph.D.
The Acquired Immunodeficiency Syndrome (AIDS) has taken on pandemic proportions
world wide, providing the health care system with the greatest challenge since its existence.
At present, infection with the Human Immunodeficiency virus (HIV) is incurable, fatal and
dangerously contagious influencing the health of the public as well as exerting profound
effects on political, social and economic circumstances of the world.
The challenge was and still is, to develop an effective treatment method for Human
Immunodeficiency Virus (HIV) infection and /or Clinical AIDS. Up to the present time no
effective treatment method has been found, as the retroviral agents typically only cause a
temporary inhibition of the progression of the HIV and not a permanent cessation of the
activity of the virus. In the absence of any pharmacological treatment, behavioral
interventions and in particular biopsychosocial interventions utilizing cognitive-behavioral
therapy and ergometric aerobic exercise take on particular importance as adjunctive
treatment methods, especially during the asymptomatic and early symptomatic HIV, (CDC
stages 2 and 3 and WR stages 2-4 A), but non-Clinical AIDS stages.
Adding Electromyographic-feedback assisted relaxation training to the above therapeutic
modalities increased the likelihood of addressing specific physiological variables associated
with HIV-seropositivity, and served as a direct operant intervention in indirectly enhancing
immune system functioning, through psychophysiological mechanisms or by means of the
relaxation effect which it produces.
In South-Africa the HIV\ AIDS situation is further compounded by a number of social and
economic factors in a society expressing rapid political changes against a background of
apartheid. Herein, issues of poverty, violence, proper medical care for HIV sufferers,
especially in the rural areas where antiviral medications and other health services are not
easily accessible, inadequate housing and unemployment place even greater burdens on the
already under-served HIV sufferer. With the above aspects in mind and considering the
seriousness of the AIDS pandemic in South-Africa as well as the absence of effective
pharmacological agents in curing this disease, an 8-week combined biopsychosocial
treatment intervention utilizing individualised cognitive-behavioral therapy, aerobic
exercise and Electromyographic-feedback assisted relaxation training was developed. The objective of this research was to determine whether the combined biopsychosocial
treatment intervention that had been developed would serve as a successful adjunctive
treatment method to the present pharmacological treatments, especially during the
asymptomatic and early symptomatic stages of HIV-infection where the apparent
sluggishness of immunological functioning may be most amenable to interventions that
enhance effector functions and communication between CD4 T-lymphocytes,
CD8 T-lymphocytes, macrophages and B cells via increases in lymphokine production.
The intervention further aimed to decrease depression, physiological tension and anxiety
and fatigue levels, as well as increase vigor-activity levels important in the overall health
status of HIV-seropositive patients. The intervention was implemented on a group of South-
African asymptomatic and early symptomatic (CDC stages 2 and 3 and WR stages 2-4 A)
HIV- seropositives.
The results of the research revealed no statistically significant between-group differences in
any of the cellular immune measurements. Clinically and statistically significant withingroup
differences were however found in baseline to post-test measures of total lymphocyte
counts in subjects of the experimental group. Statistically significant between-group
differences were also found in the tension-anxiety, depression-dejection, fatigue-inertia and
vigor-activity levels of experimental subjects as compared to control group subjects.
The study further found that subjects who recorded lower depression and tension-anxiety
levels at baseline and post-intervention phases had higher CD4 -T lymphocyte counts and
therefore, increased resistance to HIV-related infections and diseases. The study also
revealed significant within-group differences in terms of the baseline to post-test relaxation
effect of the EMG-feedback assisted relaxation training, as well as clinically significant
within-group increases in the CD4-T lymphocyte counts of experimental subjects who
experienced this relaxation effect.