ABSTRACT
Background: Cognitive decline among people living with HIV (PLWH) is growing concern as world populations become increasing older including higher proportions of PLWH. It is vitally important to understand psychosocial predictors of age-related cognitive decline men who have sex with men (MSM) living with HIV. Objectives: The current study seeks to examine psychosocial risk factors the contribute to the risk of age-related cognitive impairment as measured by Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score in a racially diverse sample of MSM living with HIV. Design: The present analysis utilizes data from the baseline (n = 196) and 6-month follow-up (n = 135) time points of a longitudinal cohort study of PLWH. Methods: Using a self-report survey, we examine the associations between psychosocial predictors (e.g. trauma, mental health, chronic pain, sleep disturbance, etc.) and risk of dementia using the CAIDE risk score. Analyses include linear and logistic regression. Results: In adjusted model stress, chronic pain, Black racial identity, and having a sexual identity that is bisexual or another category are all positively associated with CAIDE scores. Childhood sexual abuse history was negatively associated with CAIDE scores indicating a protective effect. Sleep disorder has a positive association with CAIDE scores after adjusting for the baseline CAIDE scores. Conclusion: These results indicate modifiable correlates of cognitive risk (stress and chronic pain). Interventions should seek to address these comorbid factors including the consideration of minority stress and stigma. Interventions should seek to reach Black and bisexual men living with HIV, including possible cultural tailoring to interventions and messaging. Lastly, future research should examine the impact of variation within childhood sexual abuse histories to better understand their association with cognitive impairment later in life. This may include considering the nature, severity, and potential treatment of trauma symptoms.
What makes middle-aged or older people who have HIV more likely to have memory problems later in life? We asked a racially diverse group of gay and bisexual men who have HIV. Why was the study done? Older people are becoming a larger portion of our communities including older people living with HIV. It's important to understand what makes older people more likely to have memory problems as they age including older people living with HIV. What did the researchers do? We asked 196 middle-aged and older adults who have HIV to answer questions about their health including things that we know might make them more likely to have memory problems later in life. What did the researchers find? We found that having more stress or reoccurring pain was related to being more likely to have memory problems later in life. People who have trouble sleeping were more likely to have memory problems later in life. We also found that Black people were more likely to have memory problems later in life. People who had been abused sexually as children were less likely to have memory problems later in life. What do the findings mean? These findings help us understand things that may make someone more likely to have memory problems later in life. These include things that could be changed like reoccurring pain and troubles sleeping. It also highlighted that Black people may need more support to prevent memory problems later in life.
ABSTRACT
Background: Adolescent dating violence (ADV) can have lasting effects on youth's well-being and development. However, few studies in Latin America have described its prevalence and risk factors for having experienced ADV. Methods: We conducted a multisite, cross-sectional study using two-stage cluster sampling among adolescents (14-19 years) attending public high schools in the urban districts of Panama, San Miguelito, Colón, and Arraiján/La Chorrera from 2015 to 2018 (N = 2469). All completed a tablet-based, self-administered questionnaire. Random effects logistic regression was used to identify risk factors for each ADV type among adolescent boys and girls separately. Findings: Participants reported experiencing a range of ADV at least once (girls: emotional 61.6%, physical 7.9%, sexual 21.0%; boys: emotional 73.4%, physical 24.1%, sexual 28.9%). In adjusted models, participants with a history of sexual intercourse had greater odds of ADV than those without such history across types (boys: emotional and sexual; girls: emotional, physical, and sexual). Additionally, participants who reported three or more romantic partners in the past year had greater odds of ADV than those with one partner (boys: emotional, physical; girls: physical). Girls with an earlier sexual debut (≤14 years vs ≥15 years) had greater odds of reporting ADV (emotional and sexual violence). No associations were found between reporting dating violence survival and the sex of romantic partners in the past year or the age of the current/most recent sex partner. Interpretation: This study reveals a high prevalence of ADV among adolescents in urban public schools in Panama. These findings support the need for program implementation to address ADV. Funding: Funding to undertake this study was acquired from Panama's Ministry of Economics and Finance, project number 009044.049.
