The Role of Intersectional Stigma in Coronary Artery Disease Among Cisgender Women Aging with HIV.

IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Behavioral Medicine Pub Date : 2024-11-15 DOI:10.1080/08964289.2024.2429073
Tiffany R Glynn, Michaela E Larson, Maria Bernal, Sanjana Satish, Carolina Cruzval O'Reilly, Nicholas Fonseca Nogueira, Ana Salazar Zetina, Vanessa Hurtado, Karla Inestroza, Sapna Kedia, Lilliana Vilchez, Barbara Lang, Priscilla Valls, Yoel Siegel, Chris Schettino, Eduard Ghersin, Suresh Pallikkuth, Margaret Roach, Savita Pahwa, Armando Mendez, Isabella Rosa-Cunha, Barry E Hurwitz, JoNell Potter, Mariano Kanamori, Lunthita M Duthely, Claudia Martinez
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Abstract

Cisgender women living with HIV experience elevated cardiovascular disease (CVD) risk that increases with age, a concern given extended life expectancies for people living with HIV. The CVD risk disparity among cisgender women aging with HIV is understudied and remains unclear. Taking a psychoneuroimmunology approach, given this group's intersecting marginalized identities, one potential driver of the disparity is intersectional stigma. Yet not all women living with HIV have coronary artery disease (CAD). Resilience to stigma may serve as a protective factor to CAD, as observed in other health issues. This study aimed to explore the relationship between intersectional stigma, resilience, "traditional" CVD risk factors, and objective indicators of CAD among women aging with HIV. A diverse sample of cisgender women aging with HIV (aged ≥ 35, N = 48) completed a cross-sectional survey, clinical health interview, blood sample, blood pressure, anthropometric measurements, and computed tomography angiography (CTA). CART-based machine learning models assessed the statistical importance of traditional CVD risk factors, intersectional stigma, and resilience for classifying individuals with coronary artery stenosis, calcification, and inflammatory markers associated with CAD. Of the n = 31 who completed CTA, 74% had detectable calcification and 39% stenosis. Intersectional stigma was identified as an important variable for explaining calcification, but not stenosis, and for explaining sCD163, an inflammatory biomarker associated with CAD. Results show a potential psychoneuroimmunology pathway to the CAD disparity among this group. Future longitudinal research should investigate the mechanisms of this pathway and consider stigma as target for intervention to improve cardiovascular health among women aging with HIV.

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交叉性污名在感染艾滋病毒的顺性别老年妇女冠状动脉疾病中的作用》(The Role of Intersectional Stigma in Coronary Artery Disease Among Cisgender Women Aging with HIV.
随着年龄的增长,感染艾滋病毒的顺性别女性患心血管疾病(CVD)的风险也随之升高。对感染艾滋病毒的顺性别女性的心血管疾病风险差异研究不足,目前仍不清楚。从心理神经免疫学的角度来看,考虑到这一群体的交叉边缘化身份,造成这种差异的一个潜在驱动因素是交叉污名化。然而,并非所有女性艾滋病感染者都患有冠状动脉疾病(CAD)。正如在其他健康问题中观察到的那样,抵御污名化的能力可能是冠心病的一个保护因素。本研究旨在探讨交叉性污名、复原力、"传统的 "心血管疾病风险因素以及感染艾滋病毒的老年女性中冠心病的客观指标之间的关系。不同性别的感染艾滋病毒的老年妇女样本(年龄≥ 35 岁,N = 48)完成了横断面调查、临床健康访谈、血液样本、血压、人体测量和计算机断层扫描血管造影术(CTA)。基于 CART 的机器学习模型评估了传统心血管疾病风险因素、交叉污名和复原力对冠状动脉狭窄、钙化和与 CAD 相关的炎症标志物个体分类的统计重要性。在完成 CTA 的 31 人中,74% 发现了钙化,39% 发现了狭窄。交叉污名被认为是解释钙化而非狭窄的重要变量,也是解释与 CAD 相关的炎症生物标志物 sCD163 的重要变量。研究结果表明,心理神经免疫学可能是导致该群体患上冠状动脉粥样硬化症的原因之一。未来的纵向研究应调查这一途径的机制,并考虑将污名化作为干预目标,以改善女性艾滋病患者的心血管健康。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Behavioral Medicine
Behavioral Medicine 医学-行为科学
CiteScore
5.30
自引率
4.30%
发文量
44
审稿时长
>12 weeks
期刊介绍: Behavioral Medicine is a multidisciplinary peer-reviewed journal, which fosters and promotes the exchange of knowledge and the advancement of theory in the field of behavioral medicine, including but not limited to understandings of disease prevention, health promotion, health disparities, identification of health risk factors, and interventions designed to reduce health risks, ameliorate health disparities, enhancing all aspects of health. The journal seeks to advance knowledge and theory in these domains in all segments of the population and across the lifespan, in local, national, and global contexts, and with an emphasis on the synergies that exist between biological, psychological, psychosocial, and structural factors as they related to these areas of study and across health states. Behavioral Medicine publishes original empirical studies (experimental and observational research studies, quantitative and qualitative studies, evaluation studies) as well as clinical/case studies. The journal also publishes review articles, which provide systematic evaluations of the literature and propose alternative and innovative theoretical paradigms, as well as brief reports and responses to articles previously published in Behavioral Medicine.
期刊最新文献
Clinician Perspectives on Implementing HPV Vaccination Guidelines into Practice. Adverse Childhood Experiences and Body Mass Index Status among Children and Youth with Special Health Care Needs. Prospective Attitudes Towards Respiratory Syncytial Virus (RSV) Vaccine in Pregnant Women in Greece. The Role of Intersectional Stigma in Coronary Artery Disease Among Cisgender Women Aging with HIV. Men's Preferences for Language and Communication in Mental Health Promotion: A Qualitative Study.
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