TY - JOUR
T1 - Depression and psychosocial stress are associated with subclinical carotid atherosclerosis among women living with hiv
AU - Levy, Matthew E.
AU - Anastos, Kathryn
AU - Levine, Steven R.
AU - Plankey, Michael
AU - Castel, Amanda D.
AU - Molock, Sherry
AU - Sen, Sabyasachi
AU - Asch, Federico M.
AU - Milam, Joel
AU - Aouizerat, Bradley
AU - Weber, Kathleen M.
AU - Golub, Elizabeth T.
AU - Kaplan, Robert C.
AU - Kassaye, Seble
N1 - Funding Information:
This work was supported in part by a 2019 award from the District of Columbia Center for AIDS Research, a National Institutes of Health (NIH)–funded program (grant number AI117970), which is supported by the following NIH co-funding and participating institutes and centers: National Institute of Allergy and Infectious Diseases (NIAID); National Cancer Institute (NCI); Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); National Heart, Lung, and Blood Institute (NHLBI); National Institute on Drug Abuse (NIDA); National Institute of Mental Health (NIMH); National Institute on Aging (NIA); Fogarty International Center (FIC); National Institute of General Medical Sciences (NIGMS); National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); and Office of AIDS Research (OAR). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Data in this article were collected by WIHS. WIHS (principal investigators): Bronx WIHS (Kathryn Anastos and Anjali Sharma) (grant number U01-AI-035004); Brooklyn WIHS (Deborah Gustafson and Tracey Wilson) (grant number U01-AI-031834); Chicago WIHS (Mardge Cohen and Audrey French) (grant number U01-AI-034993); Metropolitan Washington WIHS (Seble Kassaye and Daniel Merenstein) (grant number U01-AI-034994); Connie Wofsy Women’s HIV Study, Northern California (Bradley Aouizerat and Phyllis Tien) (grant number U01-AI-034989); WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub) (grant number U01-AI-042590); Southern California WIHS (Joel Milam) (grant number U01-HD-032632) (WIHS I–WIHS IV). WIHS is funded primarily by NIAID, with additional cofunding from NICHD, NCI, NIDA, and NIMH. Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by the University of California, San Francisco Clinical & Translational Science Institute (grant number UL1-TR000004). This work was also supported by NHLBI (grant numbers R01-HL-083760, R01-HL-095140, and R21-HL-120394 to Kaplan).
Publisher Copyright:
© 2020 The Authors.
PY - 2020/7/7
Y1 - 2020/7/7
N2 - BACKGROUND: To identify reasons for increased atherosclerotic risk among women living with HIV (WLWH), we evaluated the associations between psychosocial risk factors (depressive symptoms, perceived stress, and posttraumatic stress disorder symptoms) and subclinical atherosclerosis among WLWH and HIV-negative women. METHODS AND RESULTS: Carotid artery focal plaque (localized intima-media thickness >1.5 mm) was measured using B-mode ultrasound imaging in 2004–2005 and 2010–2012 in the Women’s Interagency HIV Study. We created psychosocial risk groups using latent class analysis and defined prevalent plaque at the final measurement. We also examined repeated semiannual depression measures with respect to focal plaque formation throughout follow-up. The associations between latent class and prevalent plaque, and between depressive symptom persistence and plaque formation, were assessed separately by HIV status using multivariable logistic regression. Among 700 women (median age 47 years), 2 latent classes were identified: high (n=163) and low (n=537) psychosocial risk, with corresponding prevalence of depression (65%/13%), high stress (96%/12%), and probable posttraumatic stress disorder (46%/2%). Among WLWH, plaque prevalence was 23% and 11% in high versus low psychosocial risk classes (adjusted odds ratio [aOR], 2.12; 95% CI, 1.11–4.05) compared with 9% and 9% among HIV-negative women (aOR, 1.07; 95% CI, 0.24–4.84), respectively. New plaque formation occurred among 17% and 9% of WLWH who reported high depressive symptoms at ≥45% versus <45% of visits (aOR, 1.96; 95% CI, 1.06–3.64), compared with 9% and 7% among HIV-negative women (aOR, 0.82; 95% CI, 0.16–4.16), respectively. CONCLUSIONS: Psychosocial factors were independent atherosclerotic risk factors among WLWH. Research is needed to determine whether interventions for depression and psychosocial stress can mitigate the increased risk of atherosclerosis for WLWH.
AB - BACKGROUND: To identify reasons for increased atherosclerotic risk among women living with HIV (WLWH), we evaluated the associations between psychosocial risk factors (depressive symptoms, perceived stress, and posttraumatic stress disorder symptoms) and subclinical atherosclerosis among WLWH and HIV-negative women. METHODS AND RESULTS: Carotid artery focal plaque (localized intima-media thickness >1.5 mm) was measured using B-mode ultrasound imaging in 2004–2005 and 2010–2012 in the Women’s Interagency HIV Study. We created psychosocial risk groups using latent class analysis and defined prevalent plaque at the final measurement. We also examined repeated semiannual depression measures with respect to focal plaque formation throughout follow-up. The associations between latent class and prevalent plaque, and between depressive symptom persistence and plaque formation, were assessed separately by HIV status using multivariable logistic regression. Among 700 women (median age 47 years), 2 latent classes were identified: high (n=163) and low (n=537) psychosocial risk, with corresponding prevalence of depression (65%/13%), high stress (96%/12%), and probable posttraumatic stress disorder (46%/2%). Among WLWH, plaque prevalence was 23% and 11% in high versus low psychosocial risk classes (adjusted odds ratio [aOR], 2.12; 95% CI, 1.11–4.05) compared with 9% and 9% among HIV-negative women (aOR, 1.07; 95% CI, 0.24–4.84), respectively. New plaque formation occurred among 17% and 9% of WLWH who reported high depressive symptoms at ≥45% versus <45% of visits (aOR, 1.96; 95% CI, 1.06–3.64), compared with 9% and 7% among HIV-negative women (aOR, 0.82; 95% CI, 0.16–4.16), respectively. CONCLUSIONS: Psychosocial factors were independent atherosclerotic risk factors among WLWH. Research is needed to determine whether interventions for depression and psychosocial stress can mitigate the increased risk of atherosclerosis for WLWH.
KW - Atherosclerosis
KW - Depression
KW - HIV infection
KW - Posttraumatic stress disorder
KW - Psychological stress
KW - Women
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U2 - 10.1161/JAHA.120.016425
DO - 10.1161/JAHA.120.016425
M3 - Article
C2 - 32564652
AN - SCOPUS:85088209603
SN - 2047-9980
VL - 9
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 13
M1 - e016425
ER -
