Relationships Between Stress-Responsive Biomarkers, ART Adherence, and Viral Suppression among Adolescent Girls and Young Women Living with HIV in South Africa: An HPTN 068 Analysis

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Citation

Stoner, Marie C. D.; Kelly, Nicole K.; Gomez-Olive, F. Xavier; Kahn, Kathleen; Wagner, Danielle; Bhushan, Nivedita L.; Aiello, Allison E.; & Pettifor, Audrey E. (2023). Relationships Between Stress-Responsive Biomarkers, ART Adherence, and Viral Suppression among Adolescent Girls and Young Women Living with HIV in South Africa: An HPTN 068 Analysis. Journal of Acquired Immune Deficiency Syndrome, 92(5), 349-358. PMCID: PMC10006401

Abstract

BACKGROUND: Adolescent girls and young women (AGYW) living with HIV who have higher stress levels may be at risk of stress-related biological alterations, which could influence HIV progression and adherence to antiretroviral therapy (ART).
SETTING: We aimed to estimate associations among stress-responsive biomarkers, ART adherence, and viral suppression in AGYW living with HIV in South Africa. We also hypothesized that psychosocial stressors [eg, depression, food insecurity, low socioeconomic status (SES), and HSV-2] would be associated with higher biomarker levels.
METHODS: We used 2018/2019 data from the HIV Prevention Trials Network 068 cohort to assess associations between stress-responsive biomarkers and viral suppression (<1000 copies/mL) and ART adherence measured using dried blood spot cards. Stress-responsive biomarkers included C-reactive protein, herpes simplex virus type 1, and cytomegalovirus infection and reactivation. Associations were estimated using unadjusted log-binomial or ordinal logistic regression models.
RESULTS: In 166 AGYW living with HIV, there was no association between stress-responsive biomarkers and viral suppression or ART adherence. However, increased C-reactive protein levels were associated with higher HSV-2 infection [odds ratio (OR) 1.98; 95% confidence interval (CI) 1.11, 3.52], being a government grant recipient (OR 3.21; 95% CI: 1.30, 7.92), lower food insecurity (OR 0.34; 95% CI: 0.13, 0.90), and increased body mass index (OR 1.07; 95% CI: 1.01, 1.14).
CONCLUSIONS: High prevalence of psychosocial stressors and persistent herpesviruses in AGYW living with HIV has the potential to lead to poorer health outcomes. More research is needed to untangle relationships between economic stability, chronic disease, and chronic stress.

URL

http://dx.doi.org/10.1097/qai.0000000000003149

Reference Type

Journal Article

Year Published

2023

Journal Title

Journal of Acquired Immune Deficiency Syndrome

Author(s)

Stoner, Marie C. D.
Kelly, Nicole K.
Gomez-Olive, F. Xavier
Kahn, Kathleen
Wagner, Danielle
Bhushan, Nivedita L.
Aiello, Allison E.
Pettifor, Audrey E.

Article Type

Regular

PMCID

PMC10006401

Data Set/Study

HIV Prevention Trials Network (HPTN)

Continent/Country

South Africa

Sex/Gender

Women

ORCiD

Pettifor - 0000-0002-3387-0817
Aiello - 0000-0001-7029-2537