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Objective. This study compared written emotional disclosure and processing of trauma among a relatively rare group of people with AIDS with atypically favourable disease status with an HIV+ comparison group. The study also examined the mediational role of emotional/cognitive processing and natural killer (NK) cells.

Design. This study utilized a cross-sectional group comparison design.

Method. Two HIV+ groups, the Healthy Survivors (N = 37;>9-months with <50 CD4 cells/mm3 and asymptomatic), and an HIV+ comparison groups (N = 100) wrote essays describing their reactions to past traumas; these were scored for emotional disclosure/processing.

Results. Healthy survivors had higher levels of emotional disclosure and emotional/cognitive processing than the comparison group. Emotional/cognitive processing mediated the relationship between emotional disclosure and group membership. NK cell number mediated the relationship between emotional/cognitive processing and ‘healthy survival’.

Conclusions. The results suggest that higher levels of emotional disclosure and processing of trauma may confer health and immunological benefits to people living with HIV/AIDS.