Gregory R Tapia1, Tiffany R Glynn2, Charlene Miller3, Jennifer A Manuzak4, Courtney A Broedlow3, Angela Mcgaugh5, Emily M Cherenack6, José A Bauermeister7, Christian Grov8, Samantha E Dilworth5, Robert Parisi9, Darling Martinez9, Nichole R Klatt3, Adam W Carrico5. 1. Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois. 2. University of Miami, College of Arts and Sciences, Department of Psychology, Coral, Gables, Florida. 3. University of Minnesota, School of Medicine, Department of Surgery; Minneapolis, Minnesota. 4. Tulane National Primate Research Center, Tulane University; Division of Immunology, Covington, Los Angeles. 5. University of Miami, Miller School of Medicine, Department of Public Health Sciences, Miami, Florida. 6. Duke University, Department of Psychology and Neuroscience, Durham, North Carolina. 7. University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania. 8. City University of New York (CUNY), Graduate School of Public Health and Health, Policy, New York, New York. 9. AIDS Healthcare Foundation, Ft. Lauderdale, Florida, USA.
Abstract
OBJECTIVE: Syndemic conditions have been linked to engagement in receptive condomless anal sex (CAS) and HIV seroconversion. However, little is known about the biological pathways whereby syndemics could amplify vulnerability to HIV and other sexually transmitted infections (STIs). DESIGN: HIV-negative sexual minority men (i.e. gay, bisexual and other MSM) were recruited from four STI clinics in South Florida for a cross-sectional study. METHODS: Participants completed assessments for four syndemic conditions: depression, posttraumatic stress disorder, hazardous alcohol use and any stimulant use (i.e. any self-reported use or reactive urine toxicology results). Cytokine and chemokine levels were measured using LEGENDplex from the rectal swabs of 92 participants reporting receptive CAS and no antibiotic use in the past three months. RESULTS: After controlling for age, race/ethnicity, preexposure prophylaxis (PrEP) use and number of receptive CAS partners, a greater number of syndemic conditions was associated with higher levels of rectal cytokines/chemokines relevant to immune activation, inflammation and the expansion and maintenance of T-helper 17 target cells, including rectal interferon-gamma (β = 0.22; P = 0.047), CXCL-8 (β = 0.24; P = 0.025) and interleukin-23 (β = 0.22; P = 0.049). Elevations in rectal cytokine or chemokine levels were most pronounced among participants experiencing two or more syndemic conditions compared with those experiencing no syndemic conditions. PrEP use was independently associated with elevations in multiple rectal cytokines/chemokines. CONCLUSION: Syndemic conditions could increase biological vulnerability to HIV and other STIs in sexual minority men by potentiating rectal immune dysregulation.
OBJECTIVE: Syndemic conditions have been linked to engagement in receptive condomless anal sex (CAS) and HIV seroconversion. However, little is known about the biological pathways whereby syndemics could amplify vulnerability to HIV and other sexually transmitted infections (STIs). DESIGN: HIV-negative sexual minority men (i.e. gay, bisexual and other MSM) were recruited from four STI clinics in South Florida for a cross-sectional study. METHODS: Participants completed assessments for four syndemic conditions: depression, posttraumatic stress disorder, hazardous alcohol use and any stimulant use (i.e. any self-reported use or reactive urine toxicology results). Cytokine and chemokine levels were measured using LEGENDplex from the rectal swabs of 92 participants reporting receptive CAS and no antibiotic use in the past three months. RESULTS: After controlling for age, race/ethnicity, preexposure prophylaxis (PrEP) use and number of receptive CAS partners, a greater number of syndemic conditions was associated with higher levels of rectal cytokines/chemokines relevant to immune activation, inflammation and the expansion and maintenance of T-helper 17 target cells, including rectal interferon-gamma (β = 0.22; P = 0.047), CXCL-8 (β = 0.24; P = 0.025) and interleukin-23 (β = 0.22; P = 0.049). Elevations in rectal cytokine or chemokine levels were most pronounced among participants experiencing two or more syndemic conditions compared with those experiencing no syndemic conditions. PrEP use was independently associated with elevations in multiple rectal cytokines/chemokines. CONCLUSION: Syndemic conditions could increase biological vulnerability to HIV and other STIs in sexual minority men by potentiating rectal immune dysregulation.
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