TY  - JOUR
PY  - 2018//
TI  - Gender-based violence, physiological stress, and inflammation: a cross-sectional study
JO  - Journal of women's health (Larchmont)
A1  - Heller, Madeleine
A1  - Roberts, Sarah T.
A1  - Masese, Linnet
A1  - Ngina, Jacquiline
A1  - Chohan, Neha
A1  - Chohan, Vrasha
A1  - Shafi, Juma
A1  - McClelland, R. Scott
A1  - Brindle, Eleanor
A1  - Graham, Susan M.
SP  - 1152
EP  - 1161
VL  - 27
IS  - 9
N2  - BACKGROUND: Female sex workers (FSWs) are at high risk for gender-based violence (GBV) and HIV infection. This study aimed to identify associations between GBV exposure in the past 12 months and biomarkers of physiologic stress and inflammation that may play a role in increased HIV risk among Kenyan FSWs. <br><br>MATERIALS AND METHODS: Participating women responded to a detailed questionnaire on GBV and mental health. Plasma was collected for assessment of systemic C-reactive protein (CRP) and interleukin-6 (IL-6) levels. Hair proximal to the scalp was collected to measure cortisol concentration. CRP and IL-6 were measured by enzyme-linked immunosorbent assay, and hair cortisol concentration was determined by enzyme immunoassay. Log-transformed biomarker values were compared across GBV exposure categories using Kruskal-Wallis or Wilcoxon rank sum tests. Multivariable linear regression was used to explore associations between recent GBV and hair cortisol concentration. <br><br>RESULTS: Two hundred eighty-three women enrolled, of whom 112 (39.6%) reported physical, sexual, or emotional violence in the past 12 months, 134 (47.3%) reported more remote exposure, and 37 (13.1%) reported no exposure. CRP and IL-6 levels did not differ across groups (p = 0.57 and p = 0.62, respectively). Among 141 women who provided hair, cortisol concentrations were higher among recently exposed women compared to the other two groups combined (p = 0.02). In multivariable regression, recently exposed women had higher hair cortisol levels than remotely exposed or unexposed women (adjusted beta = 0.52, 95% confidence interval 0.02-1.02, p = 0.04). <br><br>CONCLUSIONS: While CRP and IL-6 levels did not differ by GBV category, recent GBV was associated with increased hair cortisol concentration. GBV-related increases in cortisol could affect health outcomes and merit study in relation to HIV acquisition risk.<p />  <p>Language: en</p>
LA  - en
SN  - 1540-9996
UR  - http://dx.doi.org/10.1089/jwh.2017.6743
ID  - ref1
ER  -