Positive thinking can backfire

Men's Fitness, March, 2003

For most people, concludes a Yale University study, having a positive attitude toward aging can add more than seven years to your life. For people with HIV, however, there's a fine and dangerous line between optimism and denial.

In a survey of 220 patients with HIV, researchers at the University of Pennsylvania in Philadelphia found that those who had the most confident perceptions of life expectancy were more likely to miss doses of their antiretroviral drugs and to have unsafe sex. The optimists tended to be people of color, those with more than 12 years of education, and patients with relatively substantial numbers of CD4 immune cells.

Nonadherence rates were twice as high for this group: About 26 percent of the optimists said they sometimes forgot to take their medications, compared to 13 percent of the pessimists; and 57 percent of the former said they did not always practice safer sex, as opposed to 27 percent of the latter.

The report, published in the Journal of General Internal Medicine, concludes that clinicians must "develop insight about and vigilance against these problems."