Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois.
University of Miami, College of Arts and Sciences, Department of Psychology, Coral, Gables, Florida.
AIDS. 2021 Jul 1;35(8):1295-1300. doi: 10.1097/QAD.0000000000002866.
Syndemic conditions have been linked to engagement in receptive condomless anal sex (CAS) and HIV seroconversion. However, little is known about the biological pathways whereby syndemics could amplify vulnerability to HIV and other sexually transmitted infections (STIs).
HIV-negative sexual minority men (i.e. gay, bisexual and other MSM) were recruited from four STI clinics in South Florida for a cross-sectional study.
Participants completed assessments for four syndemic conditions: depression, posttraumatic stress disorder, hazardous alcohol use and any stimulant use (i.e. any self-reported use or reactive urine toxicology results). Cytokine and chemokine levels were measured using LEGENDplex from the rectal swabs of 92 participants reporting receptive CAS and no antibiotic use in the past three months.
After controlling for age, race/ethnicity, preexposure prophylaxis (PrEP) use and number of receptive CAS partners, a greater number of syndemic conditions was associated with higher levels of rectal cytokines/chemokines relevant to immune activation, inflammation and the expansion and maintenance of T-helper 17 target cells, including rectal interferon-gamma (β = 0.22; P = 0.047), CXCL-8 (β = 0.24; P = 0.025) and interleukin-23 (β = 0.22; P = 0.049). Elevations in rectal cytokine or chemokine levels were most pronounced among participants experiencing two or more syndemic conditions compared with those experiencing no syndemic conditions. PrEP use was independently associated with elevations in multiple rectal cytokines/chemokines.
Syndemic conditions could increase biological vulnerability to HIV and other STIs in sexual minority men by potentiating rectal immune dysregulation.
综合征状况与接受无保护肛交（CAS）和 HIV 血清转化有关。然而，对于综合征如何放大易感染 HIV 和其他性传播感染（STI）的生物学途径知之甚少。
从南佛罗里达州的四家性传播感染诊所招募了 HIV 阴性的性少数群体男性（即男同性恋、双性恋和其他男男性接触者），进行一项横断面研究。
参与者完成了四项综合征状况的评估：抑郁、创伤后应激障碍、危险饮酒和任何兴奋剂使用（即任何自我报告的使用或反应性尿液毒理学结果）。92 名报告接受 CAS 且过去三个月内未使用抗生素的参与者的直肠拭子使用 LEGENDplex 测量细胞因子和趋化因子水平。
在控制年龄、种族/民族、暴露前预防（PrEP）使用和接受 CAS 伴侣数量后，更多的综合征状况与更高水平的直肠细胞因子/趋化因子相关，这些因子与免疫激活、炎症和 T 辅助 17 目标细胞的扩张和维持有关，包括直肠干扰素-γ（β=0.22；P=0.047）、CXCL-8（β=0.24；P=0.025）和白细胞介素-23（β=0.22；P=0.049）。与没有综合征状况的参与者相比，经历两种或多种综合征状况的参与者的直肠细胞因子或趋化因子水平升高更为明显。PrEP 使用与多种直肠细胞因子/趋化因子的升高独立相关。
综合征状况可能通过增强直肠免疫失调，增加性少数群体男性感染 HIV 和其他 STI 的生物学脆弱性。
