Hormones, stress, and heart disease in transgender women with HIV in LITE Plus.

Autor: Poteat TC; Division of Healthcare in Adult Populations, Duke University School of Nursing, Durham, NC, USA. Electronic address: tonia.poteat@duke.edu., Ehrig M; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA., Ahmadi H; University Statistical Consulting, Irvine, CA, USA., Malik M; Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA., Reisner SL; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA; The Fenway Institute, Fenway Health, Boston, MA, USA., Radix AE; Callen Lorde Community Health Center, New York, NY, USA; Epidemiology Department, Columbia University Mailman School of Public Health, New York, NY, USA., Malone J; Whitman-Walker Institute, Washington, DC, USA., Cannon C; Whitman-Walker Institute, Washington, DC, USA., Streed CG Jr; Department of General Internal Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA; GenderCare Center, Boston Medical Center, Boston, MA., Toribio M; Metabolism Unit, Massachusetts General Hospital, Boston, MA, USA., Cortina C; Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA., Rich A; Division of Healthcare in Adult Populations, Duke University School of Nursing, Durham, NC, USA., Mayer KH; The Fenway Institute, Fenway Health, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA., DuBois LZ; Department of Anthropology, University of Oregon, Eugene, OR, USA., Juster RP; Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada., Wirtz AL; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA., Perreira KM; Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Jazyk: angličtina
Zdroj: American journal of preventive medicine [Am J Prev Med] 2024 Oct 08. Date of Electronic Publication: 2024 Oct 08.
DOI: 10.1016/j.amepre.2024.10.001
Abstrakt: Introduction: Cardiovascular disease (CVD) is a leading cause of death among transgender women and people with HIV. Exogenous estrogen and psychosocial stressors are known risk factors for CVD. Yet, few studies have used biomarkers to examine the role of stress in CVD risk among transgender women with HIV (TWHIV). This analysis examined whether stress moderates relationships between gender-affirming hormone therapy (GAHT) duration and CVD risk among TWHIV.
Methods: This cross-sectional analysis of baseline data from an observational cohort of 108 Black and Latina TWHIV in Boston, New York, and Washington, DC, enrolled December 2020 - June 2022, measured socio-demographics, medical diagnoses, medications, smoking history, and perceived stress via interviewer-administered surveys. Physiological stress was measured with 14 biomarkers to calculate allostatic load indices (ALI). Forty participants provided saliva samples used to calculate cortisol awakening response and cortisol daily decline. The 2018 American College of Cardiology revised pooled cohort equation estimated 10-year CVD risk. Data were analyzed in 2024.
Results: GAHT duration was positively associated with CVD risk scores in bivariate regression. In multivariable linear regression models (adjusting for age, income, education), only age and ALI remained significantly associated with CVD risk scores [β 1.13, CI: 1.05, 1.21]. No stress measure significantly interacted with GAHT duration to affect CVD risk scores. In visual plots, GAHT duration increased CVD risk scores only for TWHIV experiencing the highest ALI.
Conclusions: Stress plays an important role in CVD in TWHIV. More research is needed on non-GAHT factors, which influence CVD health among transgender women.
Competing Interests: Declaration of competing interest Tonia C. Poteat serves as a research consultant for ViiV Healthcare and Merck & Co. Carl G and serves on the board of WPATH. Streed, Jr. serves as a consultant for L'Oreal, scientific advisor for the Research Institute for Gender Therapeutics, and on the board of USPATH. SLR receives royalties from McGraw Hill for co-editing the textbook, “Transgender and Gender Diverse Health Care: The Fenway Guide,” and is on the board of WPATH. All financial disclosures are unrelated to this work. All other authors report no financial disclosures.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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