Allison A Appleton, Serim Lee, Mark H Kuniholm, Elizabeth Vásquez, Mardge H Cohen, Jessica Donohue, Michelle Floris-Moore, M Reuel Friedman, Deborah Gustafson, David B Hanna, Deborah L Jones, Matthew J Mimiaga, Caitlin A Moran, Michael W Plankey, Sanyog G Shitole, Linda A Teplin, Deanna Ware, Jenni M Wise
{"title":"不良的童年经历、与性取向相关的受害以及感染和不感染艾滋病毒的男性患心血管疾病的风险","authors":"Allison A Appleton, Serim Lee, Mark H Kuniholm, Elizabeth Vásquez, Mardge H Cohen, Jessica Donohue, Michelle Floris-Moore, M Reuel Friedman, Deborah Gustafson, David B Hanna, Deborah L Jones, Matthew J Mimiaga, Caitlin A Moran, Michael W Plankey, Sanyog G Shitole, Linda A Teplin, Deanna Ware, Jenni M Wise","doi":"10.1097/QAD.0000000000004235","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Adverse childhood experiences (ACEs) are traumatic events occurring before age 18 and can increase cardiovascular disease (CVD) risk. Many sexual minority men (SMM) and men with HIV (MWH) have trauma histories and elevated CVD risk. We investigated the association between ACEs and CVD risk among SMM with and without HIV (MWH and MWOH).</p><p><strong>Design and methods: </strong>Data were from the Multicenter AIDS Cohort Study ( n = 1245; n = 650 MWOH, n = 595 MWH). Participants self-reported 20 ACEs reflecting household dysfunction and victimization. CVD risk was measured with Framingham (FRS-H) and American College of Cardiology/American Heart Association-Pooled Cohort Equation (ACC/AHA-PCE) scores. Longitudinal generalized estimating equations (GEE) using 10 years of repeated CVD measures were examined with each ACE type, total number of ACEs, and ACE latent classes.</p><p><strong>Results: </strong>The prevalence of each ACE was high, ranging from 50.3 to 83.8%. Childhood sexual orientation-related victimization was positively associated with CVD risk for MWOH ( βFRS-H = 2.95, SE = 1.48, P = 0.005; βACC/AHA-PCE = 3.31, SE = 1.48, P = 0.002) and MWH ( βFRS-H = 2.69, SE = 1.58, P = 0.03; βACC/AHA-PCE = 2.82, SE = 1.62, P = 0.03). Among MWH, ACE Class 2 (characterized by high sexual orientation-related victimization, moderate levels of parental abuse, and household dysfunction) was associated with higher CVD risk ( βFRS-H = 3.63, SE = 1.78, P = 0.03; βACC/AHA-PCE = 3.09, SE = 1.78, P = 0.05). Dose-response associations were observed for the full sample when considering the total number of ACEs, though attenuated in models stratified by HIV status.</p><p><strong>Conclusion: </strong>ACEs were associated with CVD risk among MWH and MWOH. Assessing ACE history in clinical encounters may yield important insights for the prevention and management of CVD. This study underscores the importance of trauma-informed care for this population.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1621-1631"},"PeriodicalIF":3.1000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324952/pdf/","citationCount":"0","resultStr":"{\"title\":\"Adverse childhood experiences, sexual orientation-related victimization, and cardiovascular disease risk among men with and without HIV.\",\"authors\":\"Allison A Appleton, Serim Lee, Mark H Kuniholm, Elizabeth Vásquez, Mardge H Cohen, Jessica Donohue, Michelle Floris-Moore, M Reuel Friedman, Deborah Gustafson, David B Hanna, Deborah L Jones, Matthew J Mimiaga, Caitlin A Moran, Michael W Plankey, Sanyog G Shitole, Linda A Teplin, Deanna Ware, Jenni M Wise\",\"doi\":\"10.1097/QAD.0000000000004235\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Adverse childhood experiences (ACEs) are traumatic events occurring before age 18 and can increase cardiovascular disease (CVD) risk. Many sexual minority men (SMM) and men with HIV (MWH) have trauma histories and elevated CVD risk. We investigated the association between ACEs and CVD risk among SMM with and without HIV (MWH and MWOH).</p><p><strong>Design and methods: </strong>Data were from the Multicenter AIDS Cohort Study ( n = 1245; n = 650 MWOH, n = 595 MWH). Participants self-reported 20 ACEs reflecting household dysfunction and victimization. CVD risk was measured with Framingham (FRS-H) and American College of Cardiology/American Heart Association-Pooled Cohort Equation (ACC/AHA-PCE) scores. Longitudinal generalized estimating equations (GEE) using 10 years of repeated CVD measures were examined with each ACE type, total number of ACEs, and ACE latent classes.</p><p><strong>Results: </strong>The prevalence of each ACE was high, ranging from 50.3 to 83.8%. Childhood sexual orientation-related victimization was positively associated with CVD risk for MWOH ( βFRS-H = 2.95, SE = 1.48, P = 0.005; βACC/AHA-PCE = 3.31, SE = 1.48, P = 0.002) and MWH ( βFRS-H = 2.69, SE = 1.58, P = 0.03; βACC/AHA-PCE = 2.82, SE = 1.62, P = 0.03). Among MWH, ACE Class 2 (characterized by high sexual orientation-related victimization, moderate levels of parental abuse, and household dysfunction) was associated with higher CVD risk ( βFRS-H = 3.63, SE = 1.78, P = 0.03; βACC/AHA-PCE = 3.09, SE = 1.78, P = 0.05). Dose-response associations were observed for the full sample when considering the total number of ACEs, though attenuated in models stratified by HIV status.</p><p><strong>Conclusion: </strong>ACEs were associated with CVD risk among MWH and MWOH. Assessing ACE history in clinical encounters may yield important insights for the prevention and management of CVD. This study underscores the importance of trauma-informed care for this population.</p>\",\"PeriodicalId\":7502,\"journal\":{\"name\":\"AIDS\",\"volume\":\" \",\"pages\":\"1621-1631\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324952/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAD.0000000000004235\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004235","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/14 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：不良童年经历（ace）是发生在18岁之前的创伤性事件，可增加心血管疾病（CVD）的风险。许多性少数男性（SMM）和艾滋病毒携带者（MLWH）有创伤史，心血管疾病风险较高。我们调查了携带和不携带HIV的SMM （MLWH和MLWH）中ace和CVD风险之间的关系。设计和方法：数据来自多中心艾滋病队列研究(n = 1245；n = 650 MLWH, n = 595 MLWH)。参与者自我报告了20个反映家庭功能障碍和受害的ace。用Framingham （FRS-H）和美国心脏病学会/美国心脏协会合并队列方程（ACC/AHA-PCE）评分来测量CVD风险。使用10年重复CVD测量的纵向广义估计方程对每个ACE类型、ACE总数和ACE潜在类别进行了检验。结果：各ACE的患病率均较高，为50.3% ~ 83.8%。儿童期性取向受害与MLWOH患者CVD风险呈正相关(βFRS-H = 2.95, SE = 1.48, p = 0.005；βACC / AHA-PCE = 3.31, = 1.48, p = 0.002)和MLWH(βFRS-H = 2.69, = 1.58, p = 0.03;βACC/AHA-PCE = 2.82, SE = 1.62, p = 0.03)。在MLWH中，ACE 2级（以性取向相关的高受害程度、中等程度的父母虐待和家庭功能障碍为特征）与较高的心血管疾病风险相关(βFRS-H = 3.63, SE = 1.78, p = 0.03；βACC/AHA-PCE = 3.09, SE = 1.78, p = 0.05)。当考虑到ace的总数时，在整个样本中观察到剂量-反应关联，尽管在按HIV状态分层的模型中减弱。结论：ace与MLWH和MLWH的心血管疾病风险相关。评估临床遭遇的ACE病史可能对CVD的预防和管理产生重要的见解。这项研究强调了创伤知情护理对这一人群的重要性。
Adverse childhood experiences, sexual orientation-related victimization, and cardiovascular disease risk among men with and without HIV.
Objective: Adverse childhood experiences (ACEs) are traumatic events occurring before age 18 and can increase cardiovascular disease (CVD) risk. Many sexual minority men (SMM) and men with HIV (MWH) have trauma histories and elevated CVD risk. We investigated the association between ACEs and CVD risk among SMM with and without HIV (MWH and MWOH).
Design and methods: Data were from the Multicenter AIDS Cohort Study ( n = 1245; n = 650 MWOH, n = 595 MWH). Participants self-reported 20 ACEs reflecting household dysfunction and victimization. CVD risk was measured with Framingham (FRS-H) and American College of Cardiology/American Heart Association-Pooled Cohort Equation (ACC/AHA-PCE) scores. Longitudinal generalized estimating equations (GEE) using 10 years of repeated CVD measures were examined with each ACE type, total number of ACEs, and ACE latent classes.
Results: The prevalence of each ACE was high, ranging from 50.3 to 83.8%. Childhood sexual orientation-related victimization was positively associated with CVD risk for MWOH ( βFRS-H = 2.95, SE = 1.48, P = 0.005; βACC/AHA-PCE = 3.31, SE = 1.48, P = 0.002) and MWH ( βFRS-H = 2.69, SE = 1.58, P = 0.03; βACC/AHA-PCE = 2.82, SE = 1.62, P = 0.03). Among MWH, ACE Class 2 (characterized by high sexual orientation-related victimization, moderate levels of parental abuse, and household dysfunction) was associated with higher CVD risk ( βFRS-H = 3.63, SE = 1.78, P = 0.03; βACC/AHA-PCE = 3.09, SE = 1.78, P = 0.05). Dose-response associations were observed for the full sample when considering the total number of ACEs, though attenuated in models stratified by HIV status.
Conclusion: ACEs were associated with CVD risk among MWH and MWOH. Assessing ACE history in clinical encounters may yield important insights for the prevention and management of CVD. This study underscores the importance of trauma-informed care for this population.
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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