Madeleine Heller1, Sarah T Roberts2, Linnet Masese3, Jacquiline Ngina3,4, Neha Chohan3, Vrasha Chohan4, Juma Shafi5, R Scott McClelland6, Eleanor Brindle7, Susan M Graham6. 1. 1 David Geffen School of Medicine at UCLA , Los Angeles, California. 2. 2 RTI International , San Francisco, California. 3. 3 Department of Global Health, University of Washington , Seattle, Washington. 4. 4 Department of Medicine, University of Washington , Seattle, Washington. 5. 5 Institute of Tropical and Infectious Diseases, University of Nairobi , Nairobi, Kenya . 6. 6 Department of Medicine, Global Health and Epidemiology, University of Washington , Seattle, Washington. 7. 7 Center for Studies in Demography and Ecology, University of Washington , Seattle, Washington.
Abstract
BACKGROUND: Female sex workers (FSWs) are at high risk for gender-based violence (GBV) and HIV infection. This study aimed to identify associations between GBV exposure in the past 12 months and biomarkers of physiologic stress and inflammation that may play a role in increased HIV risk among Kenyan FSWs. MATERIALS AND METHODS: Participating women responded to a detailed questionnaire on GBV and mental health. Plasma was collected for assessment of systemic C-reactive protein (CRP) and interleukin-6 (IL-6) levels. Hair proximal to the scalp was collected to measure cortisol concentration. CRP and IL-6 were measured by enzyme-linked immunosorbent assay, and hair cortisol concentration was determined by enzyme immunoassay. Log-transformed biomarker values were compared across GBV exposure categories using Kruskal-Wallis or Wilcoxon rank sum tests. Multivariable linear regression was used to explore associations between recent GBV and hair cortisol concentration. RESULTS: Two hundred eighty-three women enrolled, of whom 112 (39.6%) reported physical, sexual, or emotional violence in the past 12 months, 134 (47.3%) reported more remote exposure, and 37 (13.1%) reported no exposure. CRP and IL-6 levels did not differ across groups (p = 0.57 and p = 0.62, respectively). Among 141 women who provided hair, cortisol concentrations were higher among recently exposed women compared to the other two groups combined (p = 0.02). In multivariable regression, recently exposed women had higher hair cortisol levels than remotely exposed or unexposed women (adjusted beta = 0.52, 95% confidence interval 0.02-1.02, p = 0.04). CONCLUSIONS: While CRP and IL-6 levels did not differ by GBV category, recent GBV was associated with increased hair cortisol concentration. GBV-related increases in cortisol could affect health outcomes and merit study in relation to HIV acquisition risk.
BACKGROUND: Female sex workers (FSWs) are at high risk for gender-based violence (GBV) and HIV infection. This study aimed to identify associations between GBV exposure in the past 12 months and biomarkers of physiologic stress and inflammation that may play a role in increased HIV risk among Kenyan FSWs. MATERIALS AND METHODS: Participating women responded to a detailed questionnaire on GBV and mental health. Plasma was collected for assessment of systemic C-reactive protein (CRP) and interleukin-6 (IL-6) levels. Hair proximal to the scalp was collected to measure cortisol concentration. CRP and IL-6 were measured by enzyme-linked immunosorbent assay, and hair cortisol concentration was determined by enzyme immunoassay. Log-transformed biomarker values were compared across GBV exposure categories using Kruskal-Wallis or Wilcoxon rank sum tests. Multivariable linear regression was used to explore associations between recent GBV and hair cortisol concentration. RESULTS: Two hundred eighty-three women enrolled, of whom 112 (39.6%) reported physical, sexual, or emotional violence in the past 12 months, 134 (47.3%) reported more remote exposure, and 37 (13.1%) reported no exposure. CRP and IL-6 levels did not differ across groups (p = 0.57 and p = 0.62, respectively). Among 141 women who provided hair, cortisol concentrations were higher among recently exposed women compared to the other two groups combined (p = 0.02). In multivariable regression, recently exposed women had higher hair cortisol levels than remotely exposed or unexposed women (adjusted beta = 0.52, 95% confidence interval 0.02-1.02, p = 0.04). CONCLUSIONS: While CRP and IL-6 levels did not differ by GBV category, recent GBV was associated with increased hair cortisol concentration. GBV-related increases in cortisol could affect health outcomes and merit study in relation to HIV acquisition risk.
Entities:
Keywords:
abuse; cortisol; inflammation; physiological stress; sex work; violence
Authors: Linnet Masese; Jared M Baeten; Barbra A Richardson; Elizabeth Bukusi; Grace John-Stewart; Susan M Graham; Juma Shafi; James Kiarie; Julie Overbaugh; R Scott McClelland Journal: AIDS Date: 2015-06-01 Impact factor: 4.177
Authors: Sandra E Sephton; Firdaus S Dhabhar; Alex S Keuroghlian; Janine Giese-Davis; Bruce S McEwen; Alexei C Ionan; David Spiegel Journal: Brain Behav Immun Date: 2009-07-28 Impact factor: 7.217