ing effects of HIV testing. Both cognitive behavioral stress management and exercise training have documented efficacy in precluding the immunosuppressive effects of being tested for HIV (Esterling et al., 1992; LaPerriere et al., 1990). Although the impact of additional interventions on people with HIV has yet to be demonstrated, the salubrious effects of a range of interventions seems promising. STRUCTURING INTERVENTIONS A wide range of choices are available in structuring social work interventions for people with HIV. Coupling social work visits with medical care appointments may help change the subjective impact of health care visits. Rather than feeling demoralized as a result of being reminded that one has a fatal disease, PWAs might be encouraged to focus on garnering social support and honing useful coping skills for the impending week. Social workers can provide services in the form of groups or individual interventions. With cancer, another disease whose progression is probably dependent on immune system functioning, group therapy has been shown to increase longevity (Spiegel, Bloom, Kraemer, & Gottheil, 1989) as well as enhance the activity of particular arms of the immune system (Fawzy et al., 1990). Group interventions for PWAs may have a real advantage over individual sessions. In general samples, social support has been found to be associated with increased longevity (Berkman & Syme, 1979; House, Robbins, & Metzner, 1982) and diminished susceptibility to immune suppression (Kiecolt-Glaser et al., 1984). The importance of social support as a factor associated with decreased distress has been demonstrated in people with HIV as well (Blaney et al., 1991; Fleishman & Fogel, 1994; Hays, Catania, McKusick, & Coates, 1990; Rabkin et al., 1990; Zich & Temoshok, 1987). People with HIV may, as a group, encounter greater obstacles in gaining access to social support. Over half of PWAs have limited contact with their families of orig...
