Relationships Between Stress-Responsive Biomarkers, ART Adherence, and Viral Suppression Among Adolescent Girls and Young Women Living With HIV in South Africa: An HPTN 068 Analysis

Overview

Journal J Acquir Immune Defic Syndr

Specialty Infectious Diseases

Date 2023 Feb 2

PMID 36729676

Authors

Marie C D Stoner

Nicole K Kelly

F Xavier Gomez-Olive

Kathleen Kahn

Danielle Wagner

Nivedita L Bhushan

Allison E Aiello

Audrey E Pettifor

Affiliations

Soon will be listed here.

Abstract

Background: Adolescent girls and young women (AGYW) living with HIV who have higher stress levels may be at risk of stress-related biological alterations, which could influence HIV progression and adherence to antiretroviral therapy (ART).

Setting: We aimed to estimate associations among stress-responsive biomarkers, ART adherence, and viral suppression in AGYW living with HIV in South Africa. We also hypothesized that psychosocial stressors [eg, depression, food insecurity, low socioeconomic status (SES), and HSV-2] would be associated with higher biomarker levels.

Methods: We used 2018/2019 data from the HIV Prevention Trials Network 068 cohort to assess associations between stress-responsive biomarkers and viral suppression (<1000 copies/mL) and ART adherence measured using dried blood spot cards. Stress-responsive biomarkers included C-reactive protein, herpes simplex virus type 1, and cytomegalovirus infection and reactivation. Associations were estimated using unadjusted log-binomial or ordinal logistic regression models.

Results: In 166 AGYW living with HIV, there was no association between stress-responsive biomarkers and viral suppression or ART adherence. However, increased C-reactive protein levels were associated with higher HSV-2 infection [odds ratio (OR) 1.98; 95% confidence interval (CI) 1.11, 3.52], being a government grant recipient (OR 3.21; 95% CI: 1.30, 7.92), lower food insecurity (OR 0.34; 95% CI: 0.13, 0.90), and increased body mass index (OR 1.07; 95% CI: 1.01, 1.14).

Conclusions: High prevalence of psychosocial stressors and persistent herpesviruses in AGYW living with HIV has the potential to lead to poorer health outcomes. More research is needed to untangle relationships between economic stability, chronic disease, and chronic stress.

Citing Articles

Elevated stress-responsive biomarkers are associated with HIV acquisition in young women in rural South Africa.

Stoner M, Kelly N, Gomez-Olive F, Mall S, Wagner D, Aiello A AIDS. 2024; 38(13):1866-1873.

PMID: 39022994 PMC: 11427142. DOI: 10.1097/QAD.0000000000003981.

Trajectories of intimate partner violence and their relationship to stress among young women in South Africa: An HPTN 068 study.

Kelly N, Bhushan N, Gottfredson OShea N, Gomez-Olive F, Aiello A, Wagner L Int J Soc Psychiatry. 2024; 70(5):904-914.

PMID: 38563376 PMC: 11323414. DOI: 10.1177/00207640241239535.

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