Stress Biomarkers as Outcomes for HIV+ Prevention: Participation, Feasibility and Findings Among HIV+ Latina and African American Mothers

Abstract

Mothers living with HIV (MLH) are at high risk for acute and chronic stress, given challenges related to their HIV status, ethnicity, economic and urban living conditions. Biomarkers combined into a composite index show promise in quantifying psychosocial stress in healthy people, but have not yet been examined among MLH. According, we examined potential biomarker correlates of stress [cortisol and catecholamines from home-collected urine and basic health indicators (blood pressure, height and weight, waist-to-hip ratio) measured during an interview] among 100 poor African American and Latina mothers MLH and demographic-matched control mothers without HIV (n = 50). Participants had been enrolled in a randomized controlled trial about 18 months earlier and had either received (MLH-I) or were awaiting (MLH-W) the psychosocial intervention. Participation was high, biomarkers were correctly collected for 93% of cases, and a complete composite biomarker index (CBI) calculated for 133 mothers (mean age = 42). As predicted, MLH had a significantly higher CBI than controls, but there was no CBI difference across ethnicity or intervention group. CBI predicted CD4 counts independently after controlling for age, years since diagnosis, prior CD4 counts, medication adherence, and depression symptoms. The study demonstrates acceptability, feasibility and potential utility of community-based biomarker collections in evaluating individual differences in psychosocial stress.

Using novel methods to examine stress among HIV-positive African American men who have sex with men and women

“…Nonetheless, findings that the biomarker composite here differentiated those with and without PTSD among HIV-positive African American males replicate and extend prior work with community samples of HIV-negative, mostly White women with chronic stress (Glover et al, 2006) and poor African American and Latina women with and without HIV infection (Glover et al, 2009, 2010). Data confirm links between PTSD and: (a) child sexual abuse severity; (b) perceiving sexual abuse as the worst of all traumas experienced; (c) cumulative trauma burden, including type and frequency; and (d) risky sexual behaviors, including increased number of sexual partners, sex without a condom, and exchange sex for money or drugs.…”

“…The BC was highest among cancer mothers with PTSD, next highest among cancer mothers without PTSD, and lowest among control mothers of healthy children. BC levels have also been shown to predict disease progression among poor African American and Latina women with HIV (Glover et al, 2009). BC predicted CD4 counts (an indicator of HIV progression) after controlling for age, years since HIV diagnosis, prior CD4 counts, medication adherence, and depression symptoms (Glover et al, 2009).…”

“…BC levels have also been shown to predict disease progression among poor African American and Latina women with HIV (Glover et al, 2009). BC predicted CD4 counts (an indicator of HIV progression) after controlling for age, years since HIV diagnosis, prior CD4 counts, medication adherence, and depression symptoms (Glover et al, 2009). These peripherally measured primary and secondary biological mediators combined into a composite appear to reflect central neurobiological processes that include structural changes in the brain.…”

Psychobiological Effects of Sexual Abuse

“…As a result, the full effects of sexual abuse on development and long-term physical health across the lifespan are not well known. Studies of biological functioning in sexual abuse victims soon after an incident are limited, with most sequelae being reported retrospectively in adulthood (Burns-Loeb et al, 2002;Glover, Garcia-Aracena, Lester, Rice, & Rothram-Borus, 2010). Thus, most biological data on CSA survivors come from retrospective studies among adult women with self-reported histories of CSA.…”

Depressão em pacientes HIV positivos: a realidade de um hospital português

“…Enquanto alguns estudos mostram haver associação entre os níveis de CD4+ e a gravidade da depressão, outros rejeitam esta hipótese, não encontrando qualquer relação entre a gravidade dos sintomas depressivos e os parâmetros analíticos relacionados com a infecção pelo HIV [6,8]. Várias investigações demonstraram que o reconhecimento e tratamento precoces de depressão em pacientes soropositivos atrasam a progressão da infecção para fase de SIDA e melhoram a adesão terapêutica [6,18].…”