Abstract
Background:Biological pathways mediating the link between intimate partner violence (IPV) and increased HIV risk remain unexplored. We hypothesized that IPV-induced stress negatively affects HIV systemic immune defenses and aimed to evaluate whether IPV was associated with immune profiles linked to HIV susceptibility: CD4 activation and diminished regulatory T-cell (Treg) frequency.Methods:Seventy-five HIV-negative high-risk women were surveyed regarding their IPV experience. They provided blood, urine, and (if present) genital ulcer samples for cortisol, immune assays, and STI testing. Using flow cytometry, we assessed activated CD4+ T-cell (%HLA-DR+/ CD38+) and Treg (%CD4+CD25+FoxP3+) frequencies and phenotyping. Nonparametric tests evaluated the association between IPV and immune outcomes. Multivariate regression explored confounding and moderation of the IPV-CD4 activation pathway.Results:Lifetime IPV was associated with increased CD4+ activation (r = 0.331, P = 0.004), a shift in CD4+ phenotype from naïve to effector memory (r = 0.343, P = 0.003), and a decrease in naive (%HLA-DR+/CD45RA-) Treg frequency (r = -0.337, P = 0.003). Experiencing IPV over the past year had similar trends. After controlling for sexual IPV, lifetime physical and psychological abuse remained significantly associated with CD4+ activation (P = 0.004 and P = 0.033, respectively). After controlling for race (the only covariate linked to activation), the lifetime IPV-CD4 activation association remained significant (P = 0.012). Alcohol use and depression were identified as potential pathway moderators.Conclusion:Our data is the first to suggest an immune link between IPV and HIV, and may help explain differences at the individual level in HIV susceptibility and response to biological HIV prevention strategies. The association of psychological and physical abuse with CD4 activation independent of sexual abuse further supports the existence of a stress-induced immune pathway.
Highlights
Intimate partner violence (IPV) is defined as physical violence, sexual violence, stalking, and psychological aggression by a current or former intimate partner [1]
Additional demographic, socio-behavioral, and clinical measurements are listed in Table 1.The average past-year score for the Index of Psychological Abuse (IPA) was 37.04 +/- 24.72, for the physical violence Severity of Violence Against Women Scale (SVAWS) subscale 29.92 +/- 25.97, and for the sexual violence SVAWS subscale 3.55 +/4.73
Experience of intimate partner violence (IPV) is Associated with Increased CD4 Activation To assess whether experience of IPV was associated with higher CD4+ T cell activation, participants were surveyed regarding past-year and lifetime physical, sexual, and psychological IPV, and whole blood samples were stained using anti-CD38 and anti-HLA-DR and acquired by flow cytometry (Figure 2A, 2B, 3A, 3B)
Summary
Intimate partner violence (IPV) is defined as physical violence, sexual violence, stalking, and psychological aggression by a current or former intimate partner [1]. Two potential biological pathways explaining the increased HIV susceptibility include mucosal-level changes due to sexual www.PaiJournal.com violence-induced trauma and stress-induced systemic immune changes. While sexual IPV may cause potential changes at the mucosal level, this form of IPV together with the other IPV forms, with which it often co-occurs, may independently and additively lead to stress-induced changes in the systemic immune defenses against HIV. Biological pathways mediating the link between intimate partner violence (IPV) and increased HIV risk remain unexplored. We hypothesized that IPV-induced stress negatively affects HIV systemic immune defenses and aimed to evaluate whether IPV was associated with immune profiles linked to HIV susceptibility: CD4 activation and diminished regulatory T-cell (Treg) frequency
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
