Syndemics and pre-exposure prophylaxis are independently associated with rectal immune dysregulation in sexual minority men

Gregory R Tapia, Tiffany R Glynn, Charlene Miller, Jennifer A Manuzak, Courtney A Broedlow, Angela Mcgaugh, Emily M Cherenack, José A Bauermeister, Christian Grov, Samantha E Dilworth, Robert Parisi, Darling Martinez, Nichole R Klatt, Adam W Carrico

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Abstract

OBJECTIVE: Syndemic conditions have been linked to engagement in receptive condomless anal sex (CAS) and HIV seroconversion. However, little is known about the biological pathways whereby syndemics could amplify vulnerability to HIV and other sexually transmitted infections (STIs).

DESIGN: HIV-negative sexual minority men (i.e., gay, bisexual, and other men who have sex with men) were recruited from four STI clinics in South Florida for a cross-sectional study.

METHODS: Participants completed assessments for four syndemic conditions: depression, post-traumatic stress disorder, hazardous alcohol use, and any stimulant use (i.e., any self-reported use or reactive urine toxicology results). Cytokine and chemokine levels were measured using LEGENDplex from the rectal swabs of 92 participants reporting receptive CAS and no antibiotic use in the past three months.

RESULTS: After controlling for age, race/ethnicity, pre-exposure prophylaxis (PrEP) use, and number of receptive CAS partners, a greater number of syndemic conditions was associated with higher levels of rectal cytokines/chemokines relevant to immune activation, inflammation, and the expansion and maintenance of T-helper 17 target cells, including rectal interferon-gamma (β = 0.22; p = 0.047), CXCL-8 (β = 0.24; p = 0.025), and interleukin-23 (β = 0.22; p = 0.049). Elevations in rectal cytokine or chemokine levels were most pronounced among participants experiencing two or more syndemic conditions compared to those experiencing no syndemic conditions. PrEP use was independently associated with elevations in multiple rectal cytokines/chemokines.

CONCLUSIONS: Syndemic conditions could increase biological vulnerability to HIV and other STIs in sexual minority men by potentiating rectal immune dysregulation.

Original languageEnglish (US)
JournalAIDS (London, England)
DOIs
StateE-pub ahead of print - Mar 10 2021

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Copyright © 2021 Wolters Kluwer Health, Inc.

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