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Abstract
Objective
People living with HIV (PLWH) experience high rates of childhood maltreatment, which increases risk for posttraumatic stress disorder (PTSD). Thus, it is important to understand how HIV status interacts with childhood maltreatment to influence PTSD symptom severity and underlying psychophysiology.
Methods
The current study assessed whether HIV status interacts with childhood maltreatment to influence PTSD symptom severity and heart rate variability during a dark-enhanced startle (DES) task in 88 Black women with (n=30) and without HIV (n=58).
Results
HIV was associated with greater PTSD symptom severity only in women with low levels of childhood maltreatment (p=.024). Startle potentiation during DES was highest in women living without HIV and with high childhood maltreatment (p=.018). In women who had experienced low levels of childhood maltreatment, respiratory sinus arrhythmia (RSA) was lower during the dark phase of DES in women living without HIV than women living with HIV (WLWH), (p=.046). RSA during the light phase of DES was lower in WLWH than in women living without HIV (p=.042).
Conclusion
In the current sample of Black women, HIV status was associated with PTSD symptom severity in a manner dependent on level of childhood maltreatment, suggesting that HIV status may be an important factor to consider for behavioral and pharmacological treatment strategies for PTSD. Additionally, HIV status is associated with lower percent potentiation to darkness and lower RSA during the light phase of DES, suggesting physiological mechanisms by which HIV may contribute to PTSD symptoms in individuals exposed to low levels of childhood maltreatment.
Keywords:
Acknowledgements
This study would not have been possible without the research expertise and technical assistance of Angelo Brown and all the staff and volunteers of the Grady Trauma Project and the Women’s Interagency HIV Study.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
Vasiliki Michopoulos
Vasiliki Michopoulos, Ph.D., is an Associate Professor of Psychiatry & Behavioral Sciences and a Core Scientist at the Emory National primate Research Center. Dr. Michopoulos is co-director of the Grady Trauma Project and co-director for the TL1 Program of the Georgia Clinical and Translational Science Alliance (CTSA).
Mariana Rocha
Mariana Rocha is a Ph.D. candidate in Neuroscience at Emory University specializing in the psychophysiological consequences of trauma exposure.
Rebecca Hinrichs
Rebecca Hinrichs is the Program Director for the Grady Trauma Project and an expert in the psychophysiological consequences of trauma exposure.
Susie Turkson
Susie Turkson is a M.D./Ph.D. candidate in Neuroscience at Virginia Commonwealth University specializing in the cognitive effects of HIV in older women.
Samya Dyer
Samya Dyer, MPH, completed degrees in biology and psychology at Virginia Commonwealth University and holds a master’s in public health.
Paul Howell
Paul Howell, MS, is a Lab Technician at Virginia Commonwealth University and holds a master’s in biomedical engineering.
Elizabeth C. Heaton
Elizabeth C. Heaton completed a Ph.D. in Neuroscience at Emory University specializing in the effects of stressors on brain health.
Jakayla Hart
Jakayla Hart completed her undergraduate studies at Emory University and her M.D. at Meharry Medical College.
Abigail Powers
Abigail Powers, Ph.D., is an Associate Professor of Psychiatry & Behavioral Sciences and a co-director of the Grady Trauma Project.
Yara Mekawi
Yara Mekawi, Ph.D., is an Assistant Professor in the Department of Psychological and Brain Sciences at Louisville University and head of the Challenging Ongoing Legacies of Racism (COLOR) Lab.
Sierra Carter
Sierra Carter, Ph.D., is an Associate Professor of Psychology at Georgia State University.
Ighovwerha Ofotokun
Ighovwerha Ofotokun, M.D., is a Professor of Medicine at Emory University, Department of Medicine, Division of Infectious Diseases. He serves as the administrative PI of the MACS/WIHS Combined Cohort Study in Atlanta, the Co-Director of the Georgia CTSA KL2 Program, the administrative PI and Co-Director of Emory Building Interdisciplinary Research Careers in Women’s Health (BIRCWH).
Tanja Jovanovic
Tanja Jovanovic, Ph.D., is a Professor in the Department of Psychiatry and Behavioral Neurosciences and the David and Patricia Barron Chair for PTSD Neurobiology at Wayne State University. She is the director of the Detroit Trauma Project.
Gretchen N. Neigh
Gretchen N. Neigh, Ph.D., is a Professor of Anatomy & Neurobiology. Dr. Neigh is director of Translational Research for the VCU Institute of Women’s Health, co-director of research for BIRCWH, and co-director for the Clinical and Translational Sciences PhD Program at Virginia Commonwealth University.