Ross Emily J, Jimenez Daniel E, Ghanooni Delaram, Mendez Armando, Hirshfield Sabina, Horvath Keith J, DeVries Britt, Dilworth Samantha E, Carrico Adam W, Martinez Claudia A
Department of Public Health Sciences, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA.
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1436, Miami, FL, 33136, USA.
Int J Behav Med. 2025 Apr;32(2):267-275. doi: 10.1007/s12529-024-10288-0. Epub 2024 Apr 29.
Important gaps exist in our understanding of loneliness and biobehavioral outcomes among sexual minority men (SMM), such as faster HIV disease progression. At the same time, SMM who use methamphetamine are approximately one-third more likely than non-users to develop cardiovascular disease. This study examined associations of loneliness, stimulant use, and cardiovascular risk in SMM with and without HIV.
Participants were enrolled from August 2020 to February 2022 in a 6-month prospective cohort study. The study leveraged self-report baseline data from 103 SMM, with a subset of 56 SMM that provided a blood sample to measure markers of cardiovascular risk.
Loneliness showed negative bivariate associations with total cholesterol and LDL cholesterol in the cardiometabolic subsample (n = 56). SMM with methamphetamine use (t(101) = 2.03, p < .05; d = .42) and those that screened positive for a stimulant use disorder (t(101) = 2.07, p < .05; d = .46) had significantly higher mean loneliness scores. In linear regression analyses, negative associations of loneliness with LDL and total cholesterol were observed only among SMM who used methamphetamine.
We observed lower cholesterol in SMM reporting loneliness and methamphetamine use. Thus, in addition to the observed associations of loneliness with cholesterol, there are important medical consequences of methamphetamine use including cardiovascular risk, higher HIV acquisition risk and progression, as well as stimulant overdose death. This cross-sectional study underscores the need for clinical research to develop and test interventions targeting loneliness among SMM with stimulant use disorders.
我们对性少数男性(SMM)的孤独感与生物行为结果(如HIV疾病进展加快)的理解存在重大差距。与此同时,使用甲基苯丙胺的SMM患心血管疾病的可能性比不使用者高约三分之一。本研究调查了有无HIV的SMM中孤独感、兴奋剂使用与心血管风险之间的关联。
参与者于2020年8月至2022年2月参加了一项为期6个月的前瞻性队列研究。该研究利用了103名SMM的自我报告基线数据,其中56名SMM提供了血样以测量心血管风险标志物。
在心脏代谢亚样本(n = 56)中,孤独感与总胆固醇和低密度脂蛋白胆固醇呈负二元关联。使用甲基苯丙胺的SMM(t(101) = 2.03,p <.05;d =.42)和筛查出兴奋剂使用障碍呈阳性的SMM(t(101) = 2.07,p <.05;d =.46)的平均孤独感得分显著更高。在线性回归分析中,仅在使用甲基苯丙胺的SMM中观察到孤独感与低密度脂蛋白和总胆固醇之间的负关联。
我们观察到报告有孤独感和使用甲基苯丙胺的SMM胆固醇水平较低。因此,除了观察到的孤独感与胆固醇之间的关联外,使用甲基苯丙胺还会带来重要的医学后果,包括心血管风险、更高的HIV感染风险和疾病进展,以及兴奋剂过量死亡。这项横断面研究强调了临床研究开展和测试针对有兴奋剂使用障碍的SMM中孤独感的干预措施的必要性。