Kelly Nicole K, Stoner Marie C D, Mall Sumaya, Rowe Kirsten, Gómez-Olivé Francesc Xavier, Wagner Laura Danielle, Aiello Allison E, Kahn Kathleen, Pettifor Audrey E
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, 92093, United States.
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, United States.
Ann Behav Med. 2025 Jan 4;59(1). doi: 10.1093/abm/kaaf060.
Adolescence is a critical period when youth develop their decision-making skills and may engage in their first sexual encounters. Stress during this time can affect decision making; however, limited research has examined the relationship between biological stress correlates and sexual behavior among adolescent girls and young women (AGYW) in high-HIV incidence areas.
To examine whether stress-responsive biomarkers are longitudinally associated with sexual behaviors that are predictive of HIV.
We used data from a cohort of 897 AGYW nested within the HIV Prevention Trials 068 study in rural South Africa. Stress-responsive biomarkers were tested retrospectively from enrollment: C-reactive protein (CRP), herpes simplex virus type-1 (HSV-1) antibody titers, and cytomegalovirus (CMV) antibody titers. We estimated the longitudinal associations between each biomarker (2011-2012) and each behavior throughout follow-up (2011-2019; transactional sex, age-disparate partnerships, multiple partners, and condomless sex).
At enrollment, 25.4% (n = 228) had ever had sex, 7.0% (n = 63) had >1 partner, 7.9% (n = 71) had recent condomless sex, and 3.0% (n = 27) reported transactional sex. Compared to low CRP levels, medium and high CRP levels were associated with having an older partner (RR: 1.41 [95% CI, 1.08-1.84]; RR: 1.33 [95% CI, 1.02-1.74], respectively) and with condomless sex (RR: 1.40 [95% CI, 1.10-1.77]; RR: 1.42 [95% CI, 1.12-1.80], respectively).
Higher CRP levels were longitudinally associated with age-disparate relationships and condomless sex. Inflammation may increase AGYW's engagement in these behaviors; however, future studies should examine whether there is a stress-inflammation-sexual behavior pathway, and if so, evaluate stress-reduction interventions to promote sexual well-being.
青春期是年轻人发展决策技能并可能首次发生性行为的关键时期。这段时间的压力会影响决策；然而，在艾滋病毒高发病率地区，针对青春期女孩和年轻女性（AGYW）的生物学压力相关因素与性行为之间关系的研究有限。
研究应激反应生物标志物是否与预测艾滋病毒感染的性行为存在纵向关联。
我们使用了来自南非农村地区艾滋病毒预防试验068研究中的897名AGYW队列的数据。从入组开始对应激反应生物标志物进行回顾性检测：C反应蛋白（CRP）、单纯疱疹病毒1型（HSV-1）抗体滴度和巨细胞病毒（CMV）抗体滴度。我们估计了每种生物标志物（2011 - 2012年）与整个随访期间（2011 - 2019年；交易性行为、年龄差距较大的性伴侣关系、多个性伴侣以及无保护性行为）的每种行为之间的纵向关联。
入组时，25.4%（n = 228）曾有过性行为，7.0%（n = 63）有一个以上性伴侣，7.9%（n = 71）近期有无保护性行为，3.0%（n = 27）报告有交易性行为。与低CRP水平相比，中等和高CRP水平分别与拥有年龄较大的性伴侣（风险比：1.41 [95%置信区间，1.08 - （此处原文有误，应为1.84）]；风险比：（此处原文有误，应为1.33）[95%置信区间，1.02 - 1.74]）以及无保护性行为（风险比：1.40 [95%置信区间，1.10 - 1.77]；风险比：1.42 [95%置信区间，1.12 - 1.80]）相关。
较高的CRP水平与年龄差距较大的关系和无保护性行为存在纵向关联。炎症可能会增加AGYW参与这些行为的可能性；然而，未来的研究应探讨是否存在压力 - 炎症 - 性行为途径，如果存在，评估减轻压力的干预措施以促进性健康。
