Life course history of physical and sexual abuse is associated with cardiovascular disease risk among women living with and without HIV

Allison A. Appleton; Mark H. Kuniholm; Elizabeth Vásquez; Mardge H. Cohen; Jessica Donohue; Michelle Floris-Moore; M. Reuel Friedman; David B. Hanna; Matthew J. Mimiaga; Caitlin A. Moran; Michael W. Plankey; Linda A. Teplin; Sanyog G. Shitole; Deanna Ware; Deborah L. Jones; Jenni Wise

doi:10.1097/QAD.0000000000003822

Life course history of physical and sexual abuse is associated with cardiovascular disease risk among women living with and without HIV

Allison A. Appleton, Mark H. Kuniholm, Elizabeth Vásquez, Mardge H. Cohen, Jessica Donohue, Michelle Floris-Moore, M. Reuel Friedman, David B. Hanna, Matthew J. Mimiaga, Caitlin A. Moran, Michael W. Plankey, Linda A. Teplin, Sanyog G. Shitole, Deanna Ware, Deborah L. Jones, Jenni Wise

Research output: Contribution to journal › Article › peer-review

Abstract

Objective:Sexual and physical abuse predict cardiovascular disease (CVD) among women in the general population. Women living with HIV (WLWH) report more abuse and have higher CVD risk compared with other women, yet associations between abuse history and CVD have not been considered among WLWH. This study fills this gap, and describes possible pathways linking abuse to CVD risk among WLWH and women living without HIV (WLWOH).Methods:Using 25 years of data from the Women's Interagency HIV Study (WIHS; n = 2734; WLWH n = 1963; WLWOH n = 771), we used longitudinal generalized estimating equations (GEE) to test associations between sexual and physical abuse with CVD risk. Framingham (FRS-H) and the American College of Cardiology/American Heart Association-Pooled Cohort Equation (ACC/AHA-PCE) scores were examined. Analyses were stratified by HIV-serostatus.Results:Among WLWH, childhood sexual abuse was associated with higher CVD risk (β_FRS-H = 1.25, SE = 1.08, P = 0.005; β_ACC/AHA-PCE = 1.14, SE = 1.07, P = 0.04) compared with no abuse. Adulthood sexual abuse was associated with higher CVD risk for WLWH (β_FRS-H = 1.39, SE = 1.08, P < 0.0001) and WLWOH (β_FRS-H = 1.58, SE = 1.14, P = 0.0006). Childhood physical abuse was not associated with CVD risk for either group. Adulthood physical abuse was associated with CVD risk for WLWH (β_FRS-H = 1.44, SE = 1.07; P < 0.0001, β_ACC/AHA-PCE = 1.18, SE = 1.06, P = 0.002) and WLWOH (β_FRS-H = 1.68, SE = 1.12, P < 0.0001; β_ACC/AHA-PCE = 1.24, SE = 1.11, P = 0.03). Several pathway factors were significant, including depression, smoking, and hepatitis C infection.Conclusion:Life course abuse may increase CVD risk among WLWH and women at high risk of acquiring HIV. Some comorbidities help explain the associations. Assessing abuse experiences in clinical encounters may help contextualize cardiovascular risk among this vulnerable population and inform intervention.

Original language	English (US)
Pages (from-to)	739-750
Number of pages	12
Journal	AIDS
Volume	38
Issue number	5
DOIs	https://doi.org/10.1097/QAD.0000000000003822
State	Published - Apr 1 2024

Keywords

Women's Interagency HIV Study
cardiovascular disease
life course
longitudinal
physical abuse
sexual abuse
women living with HIV
women living without HIV

ASJC Scopus subject areas

Immunology and Allergy
Immunology
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/QAD.0000000000003822

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Appleton, A. A., Kuniholm, M. H., Vásquez, E., Cohen, M. H., Donohue, J., Floris-Moore, M., Friedman, M. R., Hanna, D. B., Mimiaga, M. J., Moran, C. A., Plankey, M. W., Teplin, L. A., Shitole, S. G., Ware, D., Jones, D. L., & Wise, J. (2024). Life course history of physical and sexual abuse is associated with cardiovascular disease risk among women living with and without HIV. AIDS, 38(5), 739-750. https://doi.org/10.1097/QAD.0000000000003822

Appleton, AA, Kuniholm, MH, Vásquez, E, Cohen, MH, Donohue, J, Floris-Moore, M, Friedman, MR, Hanna, DB, Mimiaga, MJ, Moran, CA, Plankey, MW, Teplin, LA, Shitole, SG, Ware, D, Jones, DL & Wise, J 2024, 'Life course history of physical and sexual abuse is associated with cardiovascular disease risk among women living with and without HIV', AIDS, vol. 38, no. 5, pp. 739-750. https://doi.org/10.1097/QAD.0000000000003822

@article{99c4ac2678c44f8aa4afcada790dd787,

title = "Life course history of physical and sexual abuse is associated with cardiovascular disease risk among women living with and without HIV",

abstract = "Objective:Sexual and physical abuse predict cardiovascular disease (CVD) among women in the general population. Women living with HIV (WLWH) report more abuse and have higher CVD risk compared with other women, yet associations between abuse history and CVD have not been considered among WLWH. This study fills this gap, and describes possible pathways linking abuse to CVD risk among WLWH and women living without HIV (WLWOH).Methods:Using 25 years of data from the Women's Interagency HIV Study (WIHS; n = 2734; WLWH n = 1963; WLWOH n = 771), we used longitudinal generalized estimating equations (GEE) to test associations between sexual and physical abuse with CVD risk. Framingham (FRS-H) and the American College of Cardiology/American Heart Association-Pooled Cohort Equation (ACC/AHA-PCE) scores were examined. Analyses were stratified by HIV-serostatus.Results:Among WLWH, childhood sexual abuse was associated with higher CVD risk (βFRS-H = 1.25, SE = 1.08, P = 0.005; βACC/AHA-PCE = 1.14, SE = 1.07, P = 0.04) compared with no abuse. Adulthood sexual abuse was associated with higher CVD risk for WLWH (βFRS-H = 1.39, SE = 1.08, P < 0.0001) and WLWOH (βFRS-H = 1.58, SE = 1.14, P = 0.0006). Childhood physical abuse was not associated with CVD risk for either group. Adulthood physical abuse was associated with CVD risk for WLWH (βFRS-H = 1.44, SE = 1.07; P < 0.0001, βACC/AHA-PCE = 1.18, SE = 1.06, P = 0.002) and WLWOH (βFRS-H = 1.68, SE = 1.12, P < 0.0001; βACC/AHA-PCE = 1.24, SE = 1.11, P = 0.03). Several pathway factors were significant, including depression, smoking, and hepatitis C infection.Conclusion:Life course abuse may increase CVD risk among WLWH and women at high risk of acquiring HIV. Some comorbidities help explain the associations. Assessing abuse experiences in clinical encounters may help contextualize cardiovascular risk among this vulnerable population and inform intervention.",

keywords = "Women's Interagency HIV Study, cardiovascular disease, life course, longitudinal, physical abuse, sexual abuse, women living with HIV, women living without HIV",

author = "Appleton, {Allison A.} and Kuniholm, {Mark H.} and Elizabeth V{\'a}squez and Cohen, {Mardge H.} and Jessica Donohue and Michelle Floris-Moore and Friedman, {M. Reuel} and Hanna, {David B.} and Mimiaga, {Matthew J.} and Moran, {Caitlin A.} and Plankey, {Michael W.} and Teplin, {Linda A.} and Shitole, {Sanyog G.} and Deanna Ware and Jones, {Deborah L.} and Jenni Wise",

year = "2024",

month = apr,

day = "1",

doi = "10.1097/QAD.0000000000003822",

language = "English (US)",

volume = "38",

pages = "739--750",

journal = "AIDS",

issn = "0269-9370",

publisher = "Lippincott Williams and Wilkins",

number = "5",

}

TY - JOUR

T1 - Life course history of physical and sexual abuse is associated with cardiovascular disease risk among women living with and without HIV

AU - Appleton, Allison A.

AU - Kuniholm, Mark H.

AU - Vásquez, Elizabeth

AU - Cohen, Mardge H.

AU - Donohue, Jessica

AU - Floris-Moore, Michelle

AU - Friedman, M. Reuel

AU - Hanna, David B.

AU - Mimiaga, Matthew J.

AU - Moran, Caitlin A.

AU - Plankey, Michael W.

AU - Teplin, Linda A.

AU - Shitole, Sanyog G.

AU - Ware, Deanna

AU - Jones, Deborah L.

AU - Wise, Jenni

PY - 2024/4/1

Y1 - 2024/4/1

N2 - Objective:Sexual and physical abuse predict cardiovascular disease (CVD) among women in the general population. Women living with HIV (WLWH) report more abuse and have higher CVD risk compared with other women, yet associations between abuse history and CVD have not been considered among WLWH. This study fills this gap, and describes possible pathways linking abuse to CVD risk among WLWH and women living without HIV (WLWOH).Methods:Using 25 years of data from the Women's Interagency HIV Study (WIHS; n = 2734; WLWH n = 1963; WLWOH n = 771), we used longitudinal generalized estimating equations (GEE) to test associations between sexual and physical abuse with CVD risk. Framingham (FRS-H) and the American College of Cardiology/American Heart Association-Pooled Cohort Equation (ACC/AHA-PCE) scores were examined. Analyses were stratified by HIV-serostatus.Results:Among WLWH, childhood sexual abuse was associated with higher CVD risk (βFRS-H = 1.25, SE = 1.08, P = 0.005; βACC/AHA-PCE = 1.14, SE = 1.07, P = 0.04) compared with no abuse. Adulthood sexual abuse was associated with higher CVD risk for WLWH (βFRS-H = 1.39, SE = 1.08, P < 0.0001) and WLWOH (βFRS-H = 1.58, SE = 1.14, P = 0.0006). Childhood physical abuse was not associated with CVD risk for either group. Adulthood physical abuse was associated with CVD risk for WLWH (βFRS-H = 1.44, SE = 1.07; P < 0.0001, βACC/AHA-PCE = 1.18, SE = 1.06, P = 0.002) and WLWOH (βFRS-H = 1.68, SE = 1.12, P < 0.0001; βACC/AHA-PCE = 1.24, SE = 1.11, P = 0.03). Several pathway factors were significant, including depression, smoking, and hepatitis C infection.Conclusion:Life course abuse may increase CVD risk among WLWH and women at high risk of acquiring HIV. Some comorbidities help explain the associations. Assessing abuse experiences in clinical encounters may help contextualize cardiovascular risk among this vulnerable population and inform intervention.

AB - Objective:Sexual and physical abuse predict cardiovascular disease (CVD) among women in the general population. Women living with HIV (WLWH) report more abuse and have higher CVD risk compared with other women, yet associations between abuse history and CVD have not been considered among WLWH. This study fills this gap, and describes possible pathways linking abuse to CVD risk among WLWH and women living without HIV (WLWOH).Methods:Using 25 years of data from the Women's Interagency HIV Study (WIHS; n = 2734; WLWH n = 1963; WLWOH n = 771), we used longitudinal generalized estimating equations (GEE) to test associations between sexual and physical abuse with CVD risk. Framingham (FRS-H) and the American College of Cardiology/American Heart Association-Pooled Cohort Equation (ACC/AHA-PCE) scores were examined. Analyses were stratified by HIV-serostatus.Results:Among WLWH, childhood sexual abuse was associated with higher CVD risk (βFRS-H = 1.25, SE = 1.08, P = 0.005; βACC/AHA-PCE = 1.14, SE = 1.07, P = 0.04) compared with no abuse. Adulthood sexual abuse was associated with higher CVD risk for WLWH (βFRS-H = 1.39, SE = 1.08, P < 0.0001) and WLWOH (βFRS-H = 1.58, SE = 1.14, P = 0.0006). Childhood physical abuse was not associated with CVD risk for either group. Adulthood physical abuse was associated with CVD risk for WLWH (βFRS-H = 1.44, SE = 1.07; P < 0.0001, βACC/AHA-PCE = 1.18, SE = 1.06, P = 0.002) and WLWOH (βFRS-H = 1.68, SE = 1.12, P < 0.0001; βACC/AHA-PCE = 1.24, SE = 1.11, P = 0.03). Several pathway factors were significant, including depression, smoking, and hepatitis C infection.Conclusion:Life course abuse may increase CVD risk among WLWH and women at high risk of acquiring HIV. Some comorbidities help explain the associations. Assessing abuse experiences in clinical encounters may help contextualize cardiovascular risk among this vulnerable population and inform intervention.

KW - Women's Interagency HIV Study

KW - cardiovascular disease

KW - life course

KW - longitudinal

KW - physical abuse

KW - sexual abuse

KW - women living with HIV

KW - women living without HIV

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U2 - 10.1097/QAD.0000000000003822

DO - 10.1097/QAD.0000000000003822

M3 - Article

C2 - 38126350

AN - SCOPUS:85187947595

SN - 0269-9370

VL - 38

SP - 739

EP - 750

JO - AIDS

JF - AIDS

IS - 5

ER -

Life course history of physical and sexual abuse is associated with cardiovascular disease risk among women living with and without HIV

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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