Propensity score matching evaluation of psychological stress and hair cortisol among people living with HIV in China

Xu Chen,Zhiyong Shen,Riying Lv,Shan Qiao,Shuaifeng Liu,Chengbo Zeng,Xiaoming Li

doi:10.1038/s41598-021-90922-z

Abstract

To compare the psychological stress level and hair cortisol level of people living with HIV (PLWH) with those without HIV in China, a total of 220 participants were initially enrolled in the study, including 200 PLWH and 20 people living without HIV. Psychological stress level, including quality of life, anxiety, perceived stress and psychological resilience, was self-reported in both groups with related scales. The cortisol in hair was extracted and assessed by LC-APCI-MS/MS method. Propensity score matching analysis was performed to balance the baseline covariates of the two groups, whereas the difference in psychological stress level and hair cortisol level between the two groups was compared. Furthermore, the associations between psychological stress level and cortisol level were examined. Two comparison groups were matched by 1:3 propensity score matching, which yielding 20 people living without HIV and 60 PLWH. Ultimately, in regarding to the psychological stress, the levels of the anxiety (34 vs. 26, p < 0.001), perceived stress (38.5 vs. 33, p = 0.001) and psychological resilience (31 vs. 26, p = 0.004) were higher among PLWH than those living without HIV, but the people without HIV showed higher quality of life (109 vs.116, p < 0. 001). The hair cortisol level (34.66 vs. 21.61, p = 0.002) in PLWH was higher than those living without HIV. However, there were no significant associations between psychological stress level and cortisol level (p > 0.05). The PLWH showed higher level of psychological stress and cortisol than those without HIV. No relationship was seen between psychological stress level and cortisol level in PLWH.

Highlights

Human immunodeficiency virus (HIV), which causes Acquired Immunodeficiency Syndrome (AIDS), affects up to 0.8% of the adult worldwide
Psychological stress and hair cortisol levels are likely to be affected by various confounders, such as age, gender, body mass index (BMI), and ethnicity, which can bias the results
A total of 220 participants were enrolled in the study, including 20 people living without HIV and 200 people living with HIV (PLWH)

Summary

Introduction

Human immunodeficiency virus (HIV), which causes Acquired Immunodeficiency Syndrome (AIDS), affects up to 0.8% of the adult worldwide. As one end product of the hypothalamic–pituitary–adrenal (HPA) axis, has been widely used as one of the main indicators of cumulative physiological responses associated with psychological distress[5,6] These responses are generated when people suffer from emergent external stress and help them adapt to the special environmental changes. Common sampling matrices provide measures of cortisol concentration at single point in time, they are likely affected by the time of samples collected, individual differences in circadian rhythms, and transient exposure to acute daily stressors. Compared with those traditional measurements, hair cortisol is relatively stable and could capture the long-term physiological responses related to stress. The associations between psychological distress and cortisol were examined as well

Methods

Results

Conclusion