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Life stress and cervical squamous intraepithelial lesions in women with human papillomavirus and human immunodeficiency virus.

Abstract

OBJECTIVE

Human immunodeficiency virus (HIV)-infected women are at risk for cervical intraepithelial neoplasia (CIN) and cancer due to impaired immunosurveillance over human papillomavirus (HPV) infection. Life stress has been implicated in immune decrements in HIV-infected individuals and therefore may contribute to CIN progression over time. The purpose of this study was to determine whether life stress was associated with progression and/or persistence of squamous intraepithelial lesions (SIL), the cytologic diagnosis conferred by Papanicolaou smear, after 1-year follow-up among women co-infected with HIV and HPV.

METHOD

Thirty-two HIV-infected African-American and Caribbean-American women underwent a psychosocial interview, blood draw, colposcopy, and HPV cervical swab at study entry. Using medical chart review, we then abstracted SIL diagnoses at study entry and after 1-year follow-up.

RESULTS

Hierarchical logistic regression analysis revealed that higher life stress increased the odds of developing progressive/persistent SIL over 1 year by approximately seven-fold after covarying relevant biological and behavioral control variables.

CONCLUSIONS

These findings suggest that life stress may constitute an independent risk factor for SIL progression and/or persistence in HIV-infected women. Stress management interventions may decrease risk for SIL progression/persistence in women living with HIV.

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  • Authors+Show Affiliations

    ,

    Department of Psychology, University of Miami, Coral Gables, Florida 32610-0165, USA. dpereira@hp.ufl.edu

    , , , , , , , ,

    Source

    Psychosomatic medicine 65:3 pg 427-34

    MeSH

    African Americans
    Cervical Intraepithelial Neoplasia
    Cytotoxicity Tests, Immunologic
    Disease Progression
    Female
    Florida
    Focus Groups
    HIV Infections
    Humans
    Immunocompromised Host
    Immunologic Surveillance
    Life Change Events
    Lymphocyte Subsets
    Neoplasm Recurrence, Local
    Papillomaviridae
    Papillomavirus Infections
    Pregnancy
    Pregnancy Complications, Infectious
    Prospective Studies
    Psychoneuroimmunology
    Risk Factors
    Socioeconomic Factors
    Stress, Psychological
    Tumor Virus Infections
    Uterine Cervical Neoplasms
    West Indies

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    12764216

    Citation

    Pereira, Deidre Byrnes, et al. "Life Stress and Cervical Squamous Intraepithelial Lesions in Women With Human Papillomavirus and Human Immunodeficiency Virus." Psychosomatic Medicine, vol. 65, no. 3, 2003, pp. 427-34.
    Pereira DB, Antoni MH, Danielson A, et al. Life stress and cervical squamous intraepithelial lesions in women with human papillomavirus and human immunodeficiency virus. Psychosom Med. 2003;65(3):427-34.
    Pereira, D. B., Antoni, M. H., Danielson, A., Simon, T., Efantis-Potter, J., Carver, C. S., ... O'Sullivan, M. J. (2003). Life stress and cervical squamous intraepithelial lesions in women with human papillomavirus and human immunodeficiency virus. Psychosomatic Medicine, 65(3), pp. 427-34.
    Pereira DB, et al. Life Stress and Cervical Squamous Intraepithelial Lesions in Women With Human Papillomavirus and Human Immunodeficiency Virus. Psychosom Med. 2003;65(3):427-34. PubMed PMID: 12764216.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Life stress and cervical squamous intraepithelial lesions in women with human papillomavirus and human immunodeficiency virus. AU - Pereira,Deidre Byrnes, AU - Antoni,Michael H, AU - Danielson,Aimee, AU - Simon,Trudi, AU - Efantis-Potter,JoNell, AU - Carver,Charles S, AU - Durán,Ron E F, AU - Ironson,Gail, AU - Klimas,Nancy, AU - O'Sullivan,Mary Jo, PY - 2003/5/24/pubmed PY - 2004/4/21/medline PY - 2003/5/24/entrez SP - 427 EP - 34 JF - Psychosomatic medicine JO - Psychosom Med VL - 65 IS - 3 N2 - OBJECTIVE: Human immunodeficiency virus (HIV)-infected women are at risk for cervical intraepithelial neoplasia (CIN) and cancer due to impaired immunosurveillance over human papillomavirus (HPV) infection. Life stress has been implicated in immune decrements in HIV-infected individuals and therefore may contribute to CIN progression over time. The purpose of this study was to determine whether life stress was associated with progression and/or persistence of squamous intraepithelial lesions (SIL), the cytologic diagnosis conferred by Papanicolaou smear, after 1-year follow-up among women co-infected with HIV and HPV. METHOD: Thirty-two HIV-infected African-American and Caribbean-American women underwent a psychosocial interview, blood draw, colposcopy, and HPV cervical swab at study entry. Using medical chart review, we then abstracted SIL diagnoses at study entry and after 1-year follow-up. RESULTS: Hierarchical logistic regression analysis revealed that higher life stress increased the odds of developing progressive/persistent SIL over 1 year by approximately seven-fold after covarying relevant biological and behavioral control variables. CONCLUSIONS: These findings suggest that life stress may constitute an independent risk factor for SIL progression and/or persistence in HIV-infected women. Stress management interventions may decrease risk for SIL progression/persistence in women living with HIV. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/12764216/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=12764216 DB - PRIME DP - Unbound Medicine ER -