Structural Determinants of Health and Markers of Immune Activation and Systemic Inflammation in Sexual Minority Men With and Without HIV.
Delaram GhanooniAnnesa FlentjeSabina HirshfieldKeith J HorvathPatricia I MorenoAudrey HarknessEmily J RossSamantha E DilworthSavita PahwaSuresh PallikkuthAdam W CarricoPublished in: Journal of urban health : bulletin of the New York Academy of Medicine (2024)
Among sexual minority men (SMM), HIV and use of stimulants such as methamphetamine are linked with immune activation and systemic inflammation. Throughout the COVID-19 pandemic, SMM encountered financial challenges and structural obstacles that might have uniquely contributed to immune dysregulation and systemic inflammation, beyond the impacts of HIV and stimulant use. Between August 2020 and February 2022, 72 SMM with and without HIV residing in South Florida enrolled in a COVID-19 prospective cohort study. Multiple linear regression analyses examined unemployment, homelessness, and history of arrest as structural correlates of soluble markers of immune activation (i.e., sCD14 and sCD163) and inflammation (i.e., sTNF-α receptors I and II) at baseline after adjusting for HIV status, stimulant use, and recent SARS-CoV-2 infection. Enrolled participants were predominantly Latino (59%), gay-identified (85%), and with a mean age of 38 (SD, 12) years with approximately one-third (38%) of participants living with HIV. After adjusting for HIV status, SARS-CoV-2 infection, and recent stimulant use, unemployment independently predicted higher levels of sCD163 (β = 0.24, p = 0.04) and sTNF-α receptor I (β = 0.26, p = 0.02). Homelessness (β = 0.25, p = 0.02) and history of arrest (β = 0.24, p = 0.04) independently predicted higher levels of sCD14 after adjusting for HIV status, SARS-CoV-2 infection, and recent stimulant use. Independent associations exist between structural barriers and immune activation and systemic inflammation in SMM with and without HIV. Future longitudinal research should further elucidate complex bio-behavioral mechanisms linking structural factors with immune activation and inflammation.
Keyphrases
- hiv positive
- antiretroviral therapy
- hiv testing
- hiv infected
- human immunodeficiency virus
- men who have sex with men
- hepatitis c virus
- hiv aids
- attention deficit hyperactivity disorder
- oxidative stress
- south africa
- healthcare
- public health
- mental health
- sars cov
- climate change
- cell proliferation
- cross sectional
- social media
- autism spectrum disorder
- middle aged
- risk assessment
- human health