Are violence, harmful alcohol/substance use and poor mental health associated with increased genital inflammation?: A longitudinal cohort study with HIV-negative female sex workers in Nairobi, Kenya.

Autor:	Beattie TS; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom., Pollock J; Department of Immunology, University of Toronto, Toronto, Canada., Kabuti R; Partners for Health and Development in Africa, Nairobi, Kenya., Abramsky T; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom., Kung'u M; Partners for Health and Development in Africa, Nairobi, Kenya., Babu H; Partners for Health and Development in Africa, Nairobi, Kenya., Huibner S; Department of Medicine, University of Toronto, Toronto, Canada., Udayakumar S; Department of Medicine, University of Toronto, Toronto, Canada., Nyamweya C; Partners for Health and Development in Africa, Nairobi, Kenya., Okumu M; Partners for Health and Development in Africa, Nairobi, Kenya., Mahero A; Partners for Health and Development in Africa, Nairobi, Kenya., Beksinska A; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom., Panneh M; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom., Ngurukiri P; Partners for Health and Development in Africa, Nairobi, Kenya., Irungu E; Partners for Health and Development in Africa, Nairobi, Kenya., Adhiambo W; Partners for Health and Development in Africa, Nairobi, Kenya., Muthoga P; Partners for Health and Development in Africa, Nairobi, Kenya., Seeley J; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom., Weiss H; MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom., Kaul R; Department of Medicine, University of Toronto, Toronto, Canada., Kimani J; Partners for Health and Development in Africa, Nairobi, Kenya.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2024 Aug 27; Vol. 4 (8), pp. e0003592. Date of Electronic Publication: 2024 Aug 27 (Print Publication: 2024).
DOI:	10.1371/journal.pgph.0003592
Abstrakt:	Violence, alcohol use, substance use and poor mental health have been linked with increased HIV acquisition risk, and genital inflammation enhances HIV susceptibility. We examined whether past 6 month experience of these exposures was associated with increased genital inflammation, thereby providing a biological link between these exposures and HIV acquisition risk. The Maisha Fiti study was a longitudinal mixed-methods study of female sex workers in Nairobi, Kenya. Behavioural-biological surveys were conducted at baseline (June-December 2019) and endline (June 2020-March 2021). Analyses were restricted to HIV-negative women (n = 746). Women with raised levels of at least 5 of 9 genital inflammatory cytokines were defined as having genital inflammation. Multivariable logistic regression models were used to estimate (i) baseline associations between genital inflammation and violence, harmful alcohol/substance use, and poor mental health, and (ii) longitudinal associations between these exposures at different survey rounds, and genital inflammation at follow-up. Inflammation data was available for 711 of 746 (95.3%) women at baseline; 351 (50.1%) had genital inflammation, as did 247 (46.7%) at follow-up. At baseline, 67.8% of women had experienced physical and/or sexual violence in the past 6 months, 33.9% had harmful alcohol use, 26.4% had harmful substance use, 25.5% had moderate/severe depression/anxiety, and 13.9% had post-traumatic stress disorder. In adjusted analyses, there was no evidence that these exposures were associated cross-sectionally or longitudinally with genital inflammation. We report no associations between past 6 month experience of violence, harmful alcohol/substance use, or poor mental health, and immune parameters previously associated with HIV risk. This suggests that the well-described epidemiological associations between these exposures and HIV acquisition do not appear to be mediated by genital immune changes, or that any such changes are relatively short-lived. High prevalences of these exposures suggest an urgent need for sex-worker specific violence, alcohol/substance use and mental health interventions. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2024 Beattie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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