Environmental and Psychological Stressors Underlying Anxiety & Depression; Factors in Alcohol Associated Comorbidities in PWH

Lsu Health Sciences Center, New Orleans LA

Investigators

Linked publications & trials

Abstract

Abstract LSUHSC CARC RC 1. Community Factors Underlying Anxiety & Depression in Alcohol Associated Comorbidities in PWH Associations between alcohol use, HIV, mental health, and age-related comorbidities involve complex interactions that impact multiple biological mechanisms and contribute to the overall differences in health trajectories faced by people with HIV (PWH). Higher levels of both mental and physiological changes among PWH have been associated with poorer immune status, increased viral load over time, faster disease progression, and higher rates of mortality. Chronic, hazardous alcohol use and mental health disorders have been shown to contribute to heightened inflammation and oxidative stress, weakening the immune system, increasing susceptibility to infections, and potentially influencing the progression of age-related comorbidities. However, the roles that community characteristics at the environment and individual levels play in the association of alcohol use, mental health, and age-related comorbidities in PWH remain to be fully understood. There is a critical need to consider factors that contribute to alcohol misuse and health, including additional factors that may impede optimal care, contributing to higher rates of age-related comorbidities. Economic segregation, housing, and stigma associated with HIV may prevent individuals from seeking timely medical care or disclosing their health status, which can lead to untreated or poorly managed chronic diseases. Data and preliminary results from our interdisciplinary team support our overall hypothesis that physiologic and community factors increase the prevalence of anxiety and depression symptoms--items conducive to alcohol use disorders--which, in turn, promote continued anxiety and depression. We further hypothesize that behavioral interventions that interrupt this cycle will decrease risk of age-related comorbidities in PWH. The objective of the proposed study is to use an innovative approach to better understand the intersection between alcohol misuse, community factors of health, anxiety and depression and age-related comorbidities over time among PWH. We will use an explanatory sequential mix-methods approach to test the hypothesis that anxiety and depression are in the causal pathway of alcohol misuse and age-related comorbidities. We will examine the intersection of physiological and community factors and their contribution to heightened anxiety, depression, and alcohol misuse in PWH. We will also pilot test a cognitive behavioral therapy intervention to reduce alcohol use and ameliorate anxiety and depression symptoms in PWH. The proposed studies will advance the science behind community conditions of comorbidities and care-related outcomes among PWH. Understanding and addressing the complex interconnections between alcohol, chronic comorbidities, and mental health is crucial for identifying new interventions, providing comprehensive/effective care, and improving health, decreasing age-related comorbidities in PWH.