Mind-body medicine is a new way of understanding health and disease which recognizes that emotional and psychological issues influence whether we are sick or healthy.

Mind-body research has shown that our emotions, beliefs, relationships with others and behavior habits can influence our immune system, making it stronger or weaker, and thus move us towards sickness or health. For example, we now know that severe stress and continued grief and depression can weaken the immune system, and that the support of friends, being self-assertive and physical exercise all contribute to strong immunity and health.

Researchers in mind-body medicine have studied how the mind-body connection works in HIV/AIDS since the mid-1980s. They have looked at why some people get sick and die from HIV, while others remain free of symptoms and healthy. Here are some specifics, based on medical research:

1. Beliefs: believing that you must die from being HIV-infected can trigger fear, decreases in immunity, avoidance of health-promoting behavior and ultimately result in a shorter life-span.

2. Stress: being stuck in "survival stress" for many months -- where you feel somehow unsafe or threatened -- can wear down immune system functioning and speed up the progression to developing AIDS.

3. Grief: feeling grief is normal after a significant loss of an important person, pet or cherished goal. If that grief is "held in" and not expressed for many months, it can trigger a decrease in immunity and speed up the progression of disease.

4. Self-Disclosure to Trusted Support: science has learned that talking about your problems honestly with someone you trust provides a boost to immune system functioning.

5. Life Purpose and Goals: research studies on HIV+ people who remain healthy for long periods show that these HIV+ folks typically have "reasons to live," whether they are general purposes ("I want to enjoy my friends and family") or specific goals ("I want to take a cooking class next month"). It appears that "reasons for living" provide a boost to the immune system and survival.

6. Self-Assertiveness is defined as the ability to say "no" to something you really do not want to do, and "yes" to something that you want or like. Medical research shows that being self-assertive promotes the strength and quantity of Natural Killer (NK) cells of the immune system. This is important because NK cells can kill HIV in the body and can do so in people with very low CD4 counts.

7. Body Care is defined as making sure that you are doing the right things on a regular basis to keep you body healthy. This includes being aware of your breathing patterns and correcting any problems (like shallow breathing or unconscious breath-holding). You should be drinking a minimum of eight glasses of water every day and having good nutrition and eating patterns so that all of your body, including immune cells, gets the nutrition it needs. Getting regular sleep that allows you to wake up "feeling rested" most mornings is also important.

Finally, you should be getting regular (3 times per week), moderate physical exercise. An example of moderate exercise is a 20-minute brisk walk that gets you to breath a little harder and perhaps some sweat on the forehead. Remember Natural Killer (NK) immune cells from above? Exercise also promotes the strength and quantity of these HIV-fighting NK cells.

How can you use this new information about the mind-body connection to enhance your HIV+ health? For each of the issues mentioned above, rate yourself on how well you are doing: good, OK or poor. Then, make a list of the issues rated "poor" and pick someone to talk honestly with about each problematic issue. You may want to pick different people for different issues. After the discussion, create a plan for improvement for each "poor" issue and begin working on your plan.

For more information on this topic, please check out the L.I.F.E. Program website at www.Shanti.org.

Jeffrey M. Leiphart, Ph.D. is a health psychologist and Director of the L.I.F.E. Institute at Shanti in San Francisco.