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1.
J Acquir Immune Defic Syndr ; 89(2): 183-190, 2022 02 01.
Article in English | MEDLINE | ID: mdl-34629415

ABSTRACT

INTRODUCTION: Early systemic and central nervous system viral replication and inflammation may affect brain integrity in people with HIV, leading to chronic cognitive symptoms not fully reversed by antiretroviral therapy (ART). This study examined associations between cognitive performance and markers of CNS injury associated with acute HIV infection and ART. METHODS: HIV-infected MSM and transgender women (average age: 27 years and education: 13 years) enrolled within 100 days from the estimated date of detectable infection (EDDI). A cognitive performance (NP) protocol was administered at enrollment (before ART initiation) and every 24 weeks until week 192. An overall index of cognitive performance (NPZ) was created using local normative data. Blood (n = 87) and cerebrospinal fluid (CSF; n = 29) biomarkers of inflammation and neuronal injury were examined before ART initiation. Regression analyses assessed relationships between time since EDDI, pre-ART biomarkers, and NPZ. RESULTS: Adjusting for multiple comparisons, shorter time since EDDI was associated with higher pre-ART VL and multiple biomarkers in plasma and CSF. NPZ scores were within the normative range at baseline (NPZ = 0.52) and at each follow-up visit, with a modest increase through week 192. Plasma or CSF biomarkers were not correlated with NP scores at baseline or after ART. CONCLUSIONS: Biomarkers of CNS inflammation, immune activation, and neuronal injury peak early and then decline during acute HIV infection, confirming and extending results of other studies. Neither plasma nor CSF biomarkers during acute infection corresponded to NP scores before or after sustained ART in this cohort with few psychosocial risk factors for cognitive impairment.


Subject(s)
HIV Infections , Adult , Biomarkers , Cognition , Cohort Studies , Female , HIV Infections/complications , HIV Infections/drug therapy , Humans , Inflammation/complications
2.
AIDS Behav ; 23(3): 675, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30734210

ABSTRACT

Correction to: AIDS and Behavior (2018) 1-14 https://doi.org/10.1007/s10461-018-2348-2 . In the original publication of the article, the given name of the second author was not correct. The name has been corrected with this erratum.

3.
AIDS Behav ; 23(3): 661-674, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30506474

ABSTRACT

Experiencing HIV-related stigma has important impacts on the mental health of people living with HIV, which has implications for treatment adherence, disease progression, and health outcomes. The impacts of stigma are particularly important to consider among sexual and gender minorities, who often face a disproportionate burden of HIV. To address the implications of stigma in these key populations, we leveraged a longitudinal study conducted among Peruvian sexual and gender minorities to compare the relative effects of multiple mediators affecting the relationship between experienced HIV-related stigma and psychological distress: internalized HIV-related stigma, adaptive coping, and maladaptive coping. HIV-related stigma, coping, and distress were measured, respectively, at 24 weeks, 36 weeks, and 48 weeks post-diagnosis for 145 participants from the Sabes Study. HIV-related maladaptive coping largely mediated the relationship between experienced HIV-related stigma and distress. Our findings suggest interventions targeting maladaptive coping may alleviate the mental health consequences of experiencing HIV-related stigma.


Subject(s)
Adaptation, Psychological , Anti-HIV Agents/therapeutic use , Bisexuality/psychology , HIV Infections/drug therapy , HIV Infections/psychology , Social Stigma , Stress, Psychological , Adult , Anti-HIV Agents/administration & dosage , Bisexuality/ethnology , Defense Mechanisms , Female , HIV Infections/ethnology , Homosexuality, Male/ethnology , Homosexuality, Male/psychology , Homosexuality, Male/statistics & numerical data , Humans , Longitudinal Studies , Male , Mental Health , Middle Aged , Peru , Sexual Behavior , Sexual and Gender Minorities/psychology , Sexual and Gender Minorities/statistics & numerical data , Stress, Psychological/ethnology , Stress, Psychological/psychology , Transgender Persons
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