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Impact of exposure to intimate partner violence on CD4+ and CD8+ T cell decay in HIV infected women: longitudinal study.

Jewkes R, Dunkle K, Jama-Shai N, Gray G - PLoS ONE (2015)

Bottom Line: The magnitude of change in CD4 T-cells was significantly associated with having ever experienced emotional abuse from a current partner at baseline or first HIV+ test (Coeff -132.9 95% CI -196.4, -69.4 p<0.0001) and drug use (Coeff -129.9 95% CI -238.7, -21.2 p=0.02).It was not associated with other measures.The change in CD8 T-cells was associated with having ever experienced emotional abuse at baseline or prior to the first HIV+ test (Coeff -178.4 95%CI -330.2, -26.5 p=0.02).

View Article: PubMed Central - PubMed

Affiliation: Gender & Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa; School of Public Health, University of the Witwatersrand, Gauteng, South Africa.

ABSTRACT
Intimate partner violence (IPV) is a risk factor for HIV acquisition in many settings, but little is known about its impact on cellular immunity especially in HIV infected women, and if any impact differs according to the form of IPV. We tested hypotheses that exposure to IPV, non-partner rape, hunger, pregnancy, depression and substance abuse predicted change in CD4+ and CD8+ T-cell count in a dataset of 103 HIV infected young women aged 15-26 enrolled in a cluster randomised controlled trial. Multiple regression models were fitted to measure rate of change in CD4 and CD8 and including terms for age, person years of CD4+/CD8+ T-cell observation, HIV positivity at baseline, and stratum. Exposure variables included drug use, emotional, physical or sexual IPV exposure, non-partner rape, pregnancy and food insecurity. Mean CD4+ T cell count at baseline (or first HIV+ test) was 567.6 (range 1121-114). Participants were followed for an average of 1.3 years. The magnitude of change in CD4 T-cells was significantly associated with having ever experienced emotional abuse from a current partner at baseline or first HIV+ test (Coeff -132.9 95% CI -196.4, -69.4 p<0.0001) and drug use (Coeff -129.9 95% CI -238.7, -21.2 p=0.02). It was not associated with other measures. The change in CD8 T-cells was associated with having ever experienced emotional abuse at baseline or prior to the first HIV+ test (Coeff -178.4 95%CI -330.2, -26.5 p=0.02). In young ART-naive HIV positive women gender-based violence exposure in the form of emotional abuse is associated with a faster rate of decline in markers of cellular immunity. This highlights the importance of attending to emotional abuse when studying the physiological impact of IPV experience and the mechanisms of its impact on women's health.

No MeSH data available.


Related in: MedlinePlus

Flow Chart of Follow Up and Loss to Follow Up.
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pone.0122001.g001: Flow Chart of Follow Up and Loss to Follow Up.

Mentions: To derive a variable measuring change in CD4+ T cell counts we first deducted the CD4+ T cell count at 24 months from that available at baseline. We had measures at baseline and at 24 months for 25 participants (Fig. 1). For 64/198 participants we had CD4+ T cell count measured at baseline and 12 months follow up but not at 24 months, and for 14/198 participants we had CD4+ T cell counts at 12 months and 24 months. To measure CD4 decline, we first combined these assessments of CD4/CD8 change and then we set decline = 0 for participants in whom there was an increase in CD4 over the measured period. Thus the main variable modelled was a measure of CD4 decline. CD8 was handled in the same way. For each participant we calculated the person years of CD4/CD8 observation as the time between the first and last CD4.


Impact of exposure to intimate partner violence on CD4+ and CD8+ T cell decay in HIV infected women: longitudinal study.

Jewkes R, Dunkle K, Jama-Shai N, Gray G - PLoS ONE (2015)

Flow Chart of Follow Up and Loss to Follow Up.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4376679&req=5

pone.0122001.g001: Flow Chart of Follow Up and Loss to Follow Up.
Mentions: To derive a variable measuring change in CD4+ T cell counts we first deducted the CD4+ T cell count at 24 months from that available at baseline. We had measures at baseline and at 24 months for 25 participants (Fig. 1). For 64/198 participants we had CD4+ T cell count measured at baseline and 12 months follow up but not at 24 months, and for 14/198 participants we had CD4+ T cell counts at 12 months and 24 months. To measure CD4 decline, we first combined these assessments of CD4/CD8 change and then we set decline = 0 for participants in whom there was an increase in CD4 over the measured period. Thus the main variable modelled was a measure of CD4 decline. CD8 was handled in the same way. For each participant we calculated the person years of CD4/CD8 observation as the time between the first and last CD4.

Bottom Line: The magnitude of change in CD4 T-cells was significantly associated with having ever experienced emotional abuse from a current partner at baseline or first HIV+ test (Coeff -132.9 95% CI -196.4, -69.4 p<0.0001) and drug use (Coeff -129.9 95% CI -238.7, -21.2 p=0.02).It was not associated with other measures.The change in CD8 T-cells was associated with having ever experienced emotional abuse at baseline or prior to the first HIV+ test (Coeff -178.4 95%CI -330.2, -26.5 p=0.02).

View Article: PubMed Central - PubMed

Affiliation: Gender & Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa; School of Public Health, University of the Witwatersrand, Gauteng, South Africa.

ABSTRACT
Intimate partner violence (IPV) is a risk factor for HIV acquisition in many settings, but little is known about its impact on cellular immunity especially in HIV infected women, and if any impact differs according to the form of IPV. We tested hypotheses that exposure to IPV, non-partner rape, hunger, pregnancy, depression and substance abuse predicted change in CD4+ and CD8+ T-cell count in a dataset of 103 HIV infected young women aged 15-26 enrolled in a cluster randomised controlled trial. Multiple regression models were fitted to measure rate of change in CD4 and CD8 and including terms for age, person years of CD4+/CD8+ T-cell observation, HIV positivity at baseline, and stratum. Exposure variables included drug use, emotional, physical or sexual IPV exposure, non-partner rape, pregnancy and food insecurity. Mean CD4+ T cell count at baseline (or first HIV+ test) was 567.6 (range 1121-114). Participants were followed for an average of 1.3 years. The magnitude of change in CD4 T-cells was significantly associated with having ever experienced emotional abuse from a current partner at baseline or first HIV+ test (Coeff -132.9 95% CI -196.4, -69.4 p<0.0001) and drug use (Coeff -129.9 95% CI -238.7, -21.2 p=0.02). It was not associated with other measures. The change in CD8 T-cells was associated with having ever experienced emotional abuse at baseline or prior to the first HIV+ test (Coeff -178.4 95%CI -330.2, -26.5 p=0.02). In young ART-naive HIV positive women gender-based violence exposure in the form of emotional abuse is associated with a faster rate of decline in markers of cellular immunity. This highlights the importance of attending to emotional abuse when studying the physiological impact of IPV experience and the mechanisms of its impact on women's health.

No MeSH data available.


Related in: MedlinePlus