Population Levels of Psychological Stress, Herpesvirus Reactivation and HIV
Population Levels of Psychological Stress, Herpesvirus Reactivation and HIV
复制标题
DOI：
10.1007/s10461-008-9358-4
复制
发表时间：
2010-04-01
影响因子：
4.4
通讯作者：
Galea, Sandro
中科院分区：
文献类型：
--
作者：
Aiello, Allison E.;Simanek, Amanda M.;Galea, Sandro
每年有近4万美国人新感染人类免疫缺陷病毒(HIV)。最近，研究表明，群体特征与艾滋病毒/获得性免疫缺陷综合症(艾滋病)和其他性传播疾病的流行和发病率之间存在关联。先前提出的解释这些关联的两种机制是对危险行为的邻里效应和社会或制度政策。在这篇文章中，我们通过回顾研究这些途径的现有数据，假设人口水平上的逆境，如邻里贫困，也通过应激介导的免疫易感性异常来影响艾滋病毒风险。特别是，我们回顾了如下证据：(1)邻里生态应激源影响邻居和个人的心理健康、心理社会应激和艾滋病毒/艾滋病风险水平；(2)个人水平的心理社会应激源通过应激相关的激素变化影响从艾滋病毒到艾滋病的进展；(3)个人水平的心理社会应激源通过应激相关的潜伏疱疹病毒，特别是EBV和HSV-2的重新激活来影响艾滋病毒的获得。我们的综述指出，需要进一步的研究来检验邻里水平的心理社会应激源、与应激相关的HSV-2和EBV的重新激活以及艾滋病毒获得率增加之间的联合途径。我们建议使用一个多层次的框架来针对HIV预防工作，不仅涉及行为风险因素，还包括与邻里劣势、心理社会压力水平以及预防或治疗HSV-2和EBV相关的结构性、政治性和制度性因素。
Nearly 40,000 Americans are newly infected with Human Immunodeficiency Virus (HIV) each year. Recently, studies have demonstrated associations between group-level characteristics and the prevalence and incidence of HIV/Acquired Immune Deficiency Syndrome (AIDS) and other sexually transmitted diseases. Two mechanisms previously posited to explain these associations are neighborhood effects on risk behaviors and social or institutional policies. In this paper, we hypothesize that adversity at the population level, such as neighborhood poverty, also influences HIV risk through stress-mediated aberrations in immunological susceptibility by reviewing existing data examining each of these pathways. In particular, we review the evidence showing that: (1) Neighborhood ecologic stressors influence neighborhood- and individual-levels of mental health, psychosocial stress, and HIV/AIDS risk, (2) Individual-level psychosocial stressors influence progression from HIV to AIDS through stress-related hormonal changes, and (3) Individual-level psychosocial stressors influence HIV acquisition via stress-related reactivation of latent herpesviruses, specifically EBV and HSV-2. Our review indicates that further studies are needed to examine the joint pathways linking neighborhood-level sources of psychosocial stress, stress-related reactivation of HSV-2 and EBV, and increased acquisition rates of HIV. We suggest using a multi-level framework for targeting HIV prevention efforts that address not only behavioral risk factors, but structural, political, and institutional factors associated with neighborhood disadvantage, levels of psychosocial stress, and prevention or treatment of HSV-2 and EBV.