Do brain differences influence HIV risk behavior? A study of young urban women

大脑差异会影响艾滋病毒危险行为吗？

• 批准号: 8513416
• 负责人: Anna Rose Childress
• 金额: $ 19.2万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-18 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8513416
• 关键词: AIDS prevention; Accounting; Address; Adolescence; Adolescent; Adult; Affect; African American; Age; Attention deficit hyperactivity disorder; Behavior; Behavior Therapy; Behavioral; Biological; Brain; Brain region; Characteristics; Cities; Clinic; Clinical; Cognitive; Coitus; Data; Data Set; Databases; Decision Making; Development; Developmental Delay Disorders; Epidemic; Ethnic Origin; Family Planning; Female; Functional Magnetic Resonance Imaging; Funding; Goals; HIV; HIV Infections; HIV risk; Health; Healthcare; Heating; Impulsivity; Income; Individual; Infection prevention; Intervention; Life; Link; Mental Depression; Minority; Mission; Paper; Pattern; Phenotype; Population; Prevention; Prevention Research; Preventive Intervention; Process; Public Health; Publishing; Pump; Race; Recruitment Activity; Reproductive Health; Research; Rewards; Risk; Risk Behaviors; Risk-Taking; Scanning; Sexual Partners; Sexually Transmitted Diseases; Specific qualifier value; Subgroup; Surveys; Syndrome; Testing; Time; Unsafe Sex; Woman; analog; base; brain behavior; design; high risk; improved; interest; news; novel; novel strategies; partner violence; pediatric trauma; response; safer sex; sex; sexually active; skills; social; urban area; young woman

DESCRIPTION (provided by applicant): Young, urban minority women account for a growing number of new HIV/sexually transmitted infections (STIs), while prevention efforts are seriously lagging behind. Our overarching hypothesis is that efficacy of standard HIV interventions may be undermined in certain individuals by brain differences in the ability to make optimal "in the heat of the moment" risk decisions. In normal development, the reward-sensitive, impulse-driven brain of adolescence gradually becomes an adult brain with improved inhibition of reward impulses. This brain maturation, however, has a great deal of individual variability - and developmental delay (temporary or sustained) can result in a chronological adult with decision-making characteristics of an 'adolescent' brain. Based on our pilot dataset (n=142), we hypothesize that developmental delay may contribute to sub-optimal sexual decision-making (reflected in a cluster of risk behaviors - including early age of 1st sex, frequent unprotected sex, multiple sexual partners, multiple STIs) putting a subgroup of young women, at high sexual risk (HSR) for HIV. Do young women with this HSR phenotype indeed have a pattern of "younger" brain- behavioral vulnerabilities (BBVs are reward-relevant brain processes that can undermine optimal decision- making)? A between-groups design (HSR vs. low sexual risk, LSR) will recruit 18-24 year-old females from an urban family planning in a city with 5 times the national HIV rate with blacks accounting for 66% of new HIV cases. The study will compare BBVs for the HSR v LSR group in 4 domains with HIV risk-relevance (heightened reward sensitivity, greater risk taking and poor inhibition of reward impulses, and greater rejection sensitivity), using selected fMRI probes and behavioral tasks. The specific aim of our pioneering "proof-of- concept" R21 study is to determine whether young urban women with HSR have greater BBVs compared to those that have LSR. To accomplish this we will: A) Compare activation in a priori regions of the brain between those with HSR vs. LSR and~ B) Correlate brain activation patterns obtained in the on-scanner tasks with linked (off-scanner) behavioral scores. We hypothesize that those with HSR will evidence significantly greater vulnerability (greater response in a priori regions) in one or more domains relevant for HIV risk, and that behavioral scores will be significantly correlated with the brain activity in the specified a prior regions of interest, directly linking brain activity with the risk-relevant behavior. Our exploratoy aim is to characterize demographic, health and HIV risk behaviors of the HSR and LSR groups through survey assessment, providing an hypothesis-generating data-base for examining other potential associations (childhood trauma, partner violence, depression, cognitive ability) with our HIV risk-relevant brain data. Demonstrating a difference in BBVs for young women at HSR v. LSR for HIV and identifying the underlying brain processes would enable our long-term goals: to encourage a broader biologically-based understanding of HIV risk, and to open the way for new brain-targeted and/or brain-informed strategies for vulnerable individuals, with life-saving benefit.

描述（由申请人提供）：年轻的城市少数族裔妇女解释了越来越多的新艾滋病毒/性传播感染（ETI），而预防工作则严重落后。我们的总体假设是，标准艾滋病毒干预措施的疗效可能会因大脑差异而在某些人的“瞬间”风险决策中的大脑差异来破坏某些人。在正常发育中，奖励敏感的，冲动驱动的青春期大脑逐渐成为成年大脑，并改善了对奖励冲动的抑制作用。然而，这种大脑成熟具有很大的个体变异性 - 发育延迟（暂时或持续）可能会导致年代成年人具有“青少年”大脑的决策特征。 根据我们的飞行员数据集（n = 142），我们假设发展延迟可能有助于次级性性决策（反映在一系列风险行为中 - 包括第一性别的幼年，经常进行无保护的性别，多个性伴侣，多个性伴侣，多个性病），将年轻妇女的一部分为高级妇女，以高性的性风险（HSR）为HSR（HSR）。具有这种HSR表型的年轻女性是否确实具有“年轻”的脑行为脆弱性（BBV是奖励相关的大脑过程，可以破坏最佳决策）？组间设计（HSR与低性风险，LSR）将从一个城市的计划生育中招募18-24岁的女性，其全国艾滋病毒率是黑人的5倍，而黑人占新艾滋病毒的66％。该研究将使用选定的fMRI探针和行为任务，将HSR V LSR组的BBV比较4个具有HIV风险敏感性，更大的风险和抑制奖励敏感性的4个领域（提高奖励灵敏度，更大的风险和对奖励冲动的抑制更大）的BBV。我们开创性的“概念证明” R21研究的具体目的是确定与具有LSR的年轻城市妇女相比，HSR年轻的城市妇女是否具有更大的BBV。为此，我们将：a）在大脑的先验区域中比较HSR与LSR和〜b的激活之间的激活与在扫描仪任务中获得的大脑激活模式与链接的（外扫描器）行为得分相关联。我们假设患有HSR的人将在一个或多个与HIV风险相关的领域中明显更大的脆弱性（先验区域中的反应更大），并且该行为评分将与指定的先前兴趣区域的大脑活动显着相关，将大脑活动与风险相关的行为直接联系起来。我们的探索性目的是通过调查评估来表征HSR和LSR组的人口统计，健康和HIV风险行为，从而提供一个假设生成的数据基础，以检查其他潜在关联（儿童创伤，伴侣暴力，抑郁症，认知能力） 与艾滋病毒风险相关的大脑数据。在HSR诉LSR诉HIV的年轻女性中证明BBV有所不同，并确定基本的大脑过程将使我们的长期目标：鼓励对艾滋病毒风险有更广泛的基于生物学的理解，并为新的脑海和/或脑脑化的策略打开对弱势群体的新策略，并带有生命的利益。

项目成果

In young women, a link between childhood abuse and subliminal processing of aversive cues is moderated by impulsivity.

• DOI: 10.1186/s12888-022-03770-0
• 发表时间: 2022-03-02
• 期刊: BMC psychiatry
• 影响因子: 4.4
• 作者: Regier PS;Sinko L;Jagannathan K;Aryal S;Teitelman AM;Childress AR
• 通讯作者: Childress AR