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Article ; Online: The Relationship Between Posttraumatic Stress Disorder and Alcohol Misuse and Smoking Among Aging Men Who Have Sex With Men: No Evidence of Exercise or Volunteering Impact.

Barrett, Benjamin W / Meanley, Steven / Brennan-Ing, Mark / Haberlen, Sabina A / Ware, Deanna / Detels, Roger / Friedman, M Reuel / Plankey, Michael W

Journal of aging and health

2023 , Page(s) 8982643231215475

Abstract: Objectives: To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40 years) men who have sex with men (MSM), and ...

Abstract	Objectives: To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40 years) men who have sex with men (MSM), and if this mediation/moderation differs by HIV serostatus. Methods: Multicenter AIDS Cohort Study data were used. Three datasets with PTSD measured during different time periods (10/1/2017-3/31/2018, 898 men; 4/1/2018-9/30/2018, 890 men; 10/1/2018-3/31/2019, 895 men) were analyzed. Longitudinal mediation analyses estimated the mediation effect of exercise and volunteering on the outcomes. Results: Nine percent of MSM had evidence of PTSD. There was no statistically significant mediation effect of exercise or volunteering regardless of substance use outcome. The odds of smoking at a future visit among MSM with PTSD were approximately double those of MSM without PTSD. Results did not differ by HIV serostatus. Discussion: There is a particular need for effective smoking cessation interventions for aging MSM with PTSD.
Language	English
Publishing date	2023-11-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1045392-1
ISSN	1552-6887 ; 0898-2643
ISSN (online)	1552-6887
ISSN	0898-2643
DOI	10.1177/08982643231215475
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Article ; Online: Intersectional stigma and the non-communicable disease syndemic in the context of HIV: protocol for a multisite, observational study in the USA.

Friedman, M Reuel / Badri, Sheila / Bowleg, Lisa / Haberlen, Sabina A / Jones, Deborah L / Kempf, Mirjam-Colette / Konkle-Parker, Deborah / Kwait, Jenn / Martinson, Jeremy / Mimiaga, Matthew J / Plankey, Michael W / Stosor, Valentina / Tsai, Alexander C / Turan, Janet M / Ware, Deanna / Wu, Katherine

BMJ open

2024 Volume 14, Issue 4, Page(s) e075368

Abstract: Introduction: The increasing burden of non-communicable diseases, such as hypertension, diabetes and dyslipidaemia, presents key challenges to achieving optimal HIV care outcomes among ageing people living with HIV. These diseases are often comorbid and ...

Abstract	Introduction: The increasing burden of non-communicable diseases, such as hypertension, diabetes and dyslipidaemia, presents key challenges to achieving optimal HIV care outcomes among ageing people living with HIV. These diseases are often comorbid and are exacerbated by psychosocial and structural inequities. This interaction among multiple health conditions and social factors is referred to as a syndemic. In the USA, there are substantial disparities by social position (ie, racial, ethnic and socioeconomic status) in the prevalence and/or control of non-communicable diseases and HIV. Intersecting stigmas, such as racism, classism and homophobia, may drive these health disparities by contributing to healthcare avoidance and by contributing to a psychosocial syndemic (stress, depression, violence victimisation and substance use), reducing success along the HIV and non-communicable disease continua of care. Our hypothesis is that marginalised populations experience disparities in non-communicable disease incidence, prevalence and control, mediated by intersectional stigma and the psychosocial syndemic. Methods and analysis: Collecting data over a 4 year period, we will recruit sexual minority men (planned n=1800) enrolled in the MACS/WIHS Combined Cohort Study, a long-standing mixed-serostatus observational cohort in the USA, to investigate the following specific aims: (1) assess relationships between social position, intersectional stigma and the psychosocial syndemic among middle-aged and ageing sexual minority men, (2) assess relationships between social position and non-communicable disease incidence and prevalence and (3) assess relationships between social position and HIV and non-communicable disease continua of care outcomes, mediated by intersectional stigma and the psychosocial syndemic. Analyses will be conducted using generalised structural equation models using a cross-lagged panel model design. Ethics and dissemination: This protocol is approved as a single-IRB study (Advarra Institutional Review Board: Protocol 00068335). We will disseminate results via peer-reviewed academic journals, scientific conferences, a dedicated website, site community advisory boards and forums hosted at participating sites.
MeSH term(s)	Humans ; HIV Infections/epidemiology ; HIV Infections/psychology ; Social Stigma ; Syndemic ; Male ; United States/epidemiology ; Noncommunicable Diseases/epidemiology ; Adult ; Observational Studies as Topic ; Research Design ; Middle Aged ; Sexual and Gender Minorities/psychology ; Sexual and Gender Minorities/statistics & numerical data ; Prevalence ; Health Status Disparities ; Healthcare Disparities
Language	English
Publishing date	2024-04-25
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Observational Study ; Multicenter Study
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-075368
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Article ; Online: Integration of sexually transmitted infection (STI) services into HIV care and treatment services for women living with HIV: a systematic review.

Kennedy, Caitlin E / Haberlen, Sabina A / Narasimhan, Manjulaa

BMJ open

2017 Volume 7, Issue 6, Page(s) e015310

Abstract: Objective: To review and critically appraise the existing evidence on integration of sexually transmitted infection (STI) services into HIV care and treatment services for women living with HIV.: Design: Systematic review.: Data sources: Four ... ...

Abstract	Objective: To review and critically appraise the existing evidence on integration of sexually transmitted infection (STI) services into HIV care and treatment services for women living with HIV. Design: Systematic review. Data sources: Four electronic databases were searched through 16February 2017 using keywords for HIV, STIs and integration. Reference lists of included articles and other reviews were also screened. Review methods: We included studies that compared women living with HIV who received STI services integrated into HIV care and treatment services with those who received HIV care and treatment services without integrated STI services or standard of care. Results: Of 170 articles identified, 3 studies reported in 4 articles were included. Two studies evaluated comprehensive care for people living with HIV in the UK; in both cases, quality and uptake of STI services seemed to improve following integration. The third study conducted a comparative case study across different models of care in Swaziland: two clinics integrated with sexual and reproductive health services (including STI services), and two stand-alone HIV clinics (without STI services). Coverage for Pap smears among women living with HIV was higher at the fully integrated site, but there was no significant difference in the prevalence of sexual health screening or advice on sexual health. Reported client satisfaction was generally higher at the stand-alone HIV clinic, and a diverse range of factors related to implementation of different care models challenged the notion that integrated services are always superior or desired. Conclusion: While there is a limited evidence base for integrating STI services into HIV care and treatment services, existing studies indicate that integration is feasible and has the potential for positive outcomes. However, diverse population needs and health system factors must be considered when designing models of care to provide STI services to women living with HIV.
MeSH term(s)	Delivery of Health Care/organization & administration ; Directive Counseling ; Female ; HIV Infections/drug therapy ; Humans ; Patient Satisfaction ; Sexual Health ; Sexually Transmitted Diseases/diagnosis ; Sexually Transmitted Diseases/drug therapy
Language	English
Publishing date	2017-06-21
Publishing country	England
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2016-015310
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Article: Self-Perception of Aging and Hypertension in a Cohort of Sexual Minority.

Jacobsen, Alan P / Polanka, Brittanny M / Ware, Deanna / Haberlen, Sabina A / Brennan-Ing, Mark / Meanley, Steven / Okafor, Chukwuemeka N / Palella, Frank J / Bolan, Robert K / Friedman, M Reuel / Plankey, Michael

Cureus

2023 Volume 15, Issue 8, Page(s) e43127

Abstract: Objectives To determine whether self-perception of aging is an important marker of health and hypertension among older sexual minority men. Methods We evaluated associations between self-perception of aging (chronologic-subjective age discrepancy and ... ...

Abstract	Objectives To determine whether self-perception of aging is an important marker of health and hypertension among older sexual minority men. Methods We evaluated associations between self-perception of aging (chronologic-subjective age discrepancy and aging satisfaction) and hypertension among 1,180 sexual minority men (51.6% with HIV/48.4% without HIV) from the Multicenter AIDS Cohort Study using a manifest Markov chain model adjusted for HIV status, age, race/ethnicity, education, smoking status, inhaled nitrite use, diabetes, dyslipidemia, kidney and liver disease. Results The overall prevalence of hypertension increased from 73.1% to 82.6% over three years of follow-up. Older age discrepancy (aOR (adjusted odds ratio): 1.13 95% CI: 0.35-3.69) and low aging satisfaction (aOR: 0.88; 95% CI: 0.31-2.52) were not associated with an increased prevalence of hypertension, regardless of HIV status. Discussion More than 80% of sexual minority men had a diagnosis of hypertension but self-perception of aging was not predictive of incident hypertension.
Language	English
Publishing date	2023-08-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.43127
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Article ; Online: Advance Care Planning Among Sexual Minority Men: Sociodemographic, Health Care, and Health Status Predictors.

Siconolfi, Daniel / Thomas, Emma G / Chen, Emily K / Haberlen, Sabina A / Friedman, M Reuel / Ware, Deanna / Meanley, Steven / Brennan-Ing, Mark / Brown, Andre L / Egan, James E / Bolan, Robert / Stosor, Valentina / Plankey, Michael

Journal of aging and health

2023 Volume 36, Issue 3-4, Page(s) 147–160

Abstract: Objectives: ...

Abstract	Objectives:
MeSH term(s)	Male ; Humans ; Ethnicity ; Cohort Studies ; Minority Groups ; Advance Care Planning ; Health Status ; Delivery of Health Care
Language	English
Publishing date	2023-05-30
Publishing country	United States
Document type	Multicenter Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1045392-1
ISSN	1552-6887 ; 0898-2643
ISSN (online)	1552-6887
ISSN	0898-2643
DOI	10.1177/08982643231177725
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Article ; Online: Does Social Support Predict Depressive Symptoms? A Longitudinal Study of Midlife and Older Men Who Have Sex with Men from the Multicenter AIDS Cohort Study.

Henderson, Emmett R / Egan, James E / Haberlen, Sabina A / Detels, Roger / Teplin, Linda A / Friedman, M Reuel / Plankey, Michael W / Coulter, Robert W S

Annals of LGBTQ public and population health

2021 Volume 2, Issue 2, Page(s) 142–160

Abstract: The present study was designed to identify social support classes across time among midlife (40-64 years) and older (65+ years) gay, bisexual, and other men who have sex with men (MSM), and whether social support protects against depressive symptoms in ... ...

Abstract	The present study was designed to identify social support classes across time among midlife (40-64 years) and older (65+ years) gay, bisexual, and other men who have sex with men (MSM), and whether social support protects against depressive symptoms in this population. This study applied longitudinal latent class analysis across five visits on 1,329 individuals age 40 or older at baseline using data from the Multicenter AIDS Cohort Study (MACS) Healthy Aging substudy collected from April 2016 to October 2018. We identified four classes of social support across time:
Language	English
Publishing date	2021-10-28
Publishing country	United States
Document type	Journal Article
ISSN	2688-4518
ISSN (online)	2688-4518
DOI	10.1891/lgbtq-2020-0042
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Article ; Online: Human immunodeficiency viral infection and differences in interstitial ventricular fibrosis and left atrial size.

Wu, Katherine C / Haberlen, Sabina A / Plankey, Michael W / Palella, Frank J / Piggott, Damani A / Kirk, Gregory D / Margolick, Joseph B / Post, Wendy S

European heart journal. Cardiovascular Imaging

2021 Volume 22, Issue 8, Page(s) 888–895

Abstract: Aims: The extent to which human immunodeficiency viral (HIV) infection is independently associated with myocardial disease in the era of combination antiretroviral therapy (cART) remains understudied. We assessed differences in cardiovascular magnetic ... ...

Abstract	Aims: The extent to which human immunodeficiency viral (HIV) infection is independently associated with myocardial disease in the era of combination antiretroviral therapy (cART) remains understudied. We assessed differences in cardiovascular magnetic resonance imaging (CMR) metrics among people living with HIV (PLWH) and without HIV (PWOH). Methods and results: Among 436 participants (aged 54.7 ± 6.0 years, 29% women) from three cohorts, we acquired CMR cines, late gadolinium enhancement (LGE), and T1 mapping. Multivariable linear regressions were used to evaluate associations between HIV serostatus and CMR metrics. Baseline characteristics were similar by HIV serostatus; 63% were PLWH of whom 88% received cART and 73% were virally suppressed. Median left ventricular ejection fraction was normal and similar by HIV serostatus (73%, PWOH vs. 72%, PLWH, P = 0.43) as were right ventricular function, biventricular volumes, and masses. LGE prevalence was similar (32%, PWOH vs. 36%, PLWH, P = 0.46) with low scar extents (4.1, PWOH vs. 4.9 g, PLWH, P = 0.51) and few ischaemic scars (3%, PWOH vs. 4%, PLWH, P = 0.70). Extracellular volume fraction (ECV) was higher among PLWH (29.2 ± 4.1% vs. 28.3 ± 3.7%, P = 0.04) as was indexed maximum left atrial (LA) volume (LAVI, 29.7 ± 10.3 vs. 27.8 ± 8.7 mL/m2, P = 0.05). After multivariate adjustment, ECV was 0.84% higher among PLWH (P = 0.05) and LAVI was 2.45 mL/m2 larger (P = 0.01). HIV seropositivity and higher ECV contributed to higher LAVI (P < 0.02). There were no associations between HIV disease severity and CMR metrics among PLWH. Conclusion: HIV seropositivity was independently associated with greater diffuse non-ischaemic fibrosis and larger LA volume but no other differences in CMR metrics.
MeSH term(s)	Contrast Media ; Female ; Fibrosis ; Gadolinium ; HIV Infections/complications ; HIV Infections/diagnostic imaging ; HIV Infections/drug therapy ; Humans ; Magnetic Resonance Imaging, Cine ; Male ; Myocardium/pathology ; Predictive Value of Tests ; Stroke Volume ; Ventricular Function, Left ; Virus Diseases/pathology
Chemical Substances	Contrast Media ; Gadolinium (AU0V1LM3JT)
Language	English
Publishing date	2021-03-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2638345-7
ISSN	2047-2412 ; 2047-2404
ISSN (online)	2047-2412
ISSN	2047-2404
DOI	10.1093/ehjci/jeab037
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Article: Proteomic Signature of HIV-Associated Subclinical Left Atrial Remodeling and Incident Heart Failure.

medRxiv : the preprint server for health sciences

2024

Abstract: Background: People living with HIV (PLWH) are at higher risk of heart failure (HF) and preceding subclinical cardiac abnormalities, including left atrial dilation, compared to people without HIV (PWOH). Hypothesized mechanisms include premature aging ... ...

Abstract	Background: People living with HIV (PLWH) are at higher risk of heart failure (HF) and preceding subclinical cardiac abnormalities, including left atrial dilation, compared to people without HIV (PWOH). Hypothesized mechanisms include premature aging linked to chronic immune activation. We leveraged plasma proteomics to identify potential novel contributors to HIV-associated differences in indexed left atrial volume (LAVi) among PLWH and PWOH and externally validated identified proteomic signatures with incident HF among a cohort of older PWOH. Methods: We performed proteomics (Olink Explore 3072) on plasma obtained concurrently with cardiac magnetic resonance imaging among PLWH and PWOH in the United States. Proteins were analyzed individually and as agnostically defined clusters. Cross-sectional associations with HIV and LAVi were estimated using multivariable regression with robust variance. Among an independent general population cohort, we estimated associations between identified signatures and LAVi using linear regression and incident HF using Cox regression. Results: Among 352 participants (age 55±6 years; 25% female), 61% were PLWH (88% on ART; 73% with undetectable HIV RNA) and mean LAVi was 29±9 mL/m Conclusion: Proteomic signatures that may contribute to HIV-associated LA remodeling were enriched in immune checkpoint proteins, cytokine signaling, and ECM organization. These signatures were also associated with incident HF among older PWOH, suggesting specific markers of chronic immune activation, systemic inflammation, and fibrosis may identify shared pathways in HIV and aging that contribute to risk of HF.
Language	English
Publishing date	2024-02-14
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.02.13.24302797
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Article ; Online: Integration of Family Planning Services into HIV Care and Treatment Services: A Systematic Review.

Haberlen, Sabina A / Narasimhan, Manjulaa / Beres, Laura K / Kennedy, Caitlin E

Studies in family planning

2017 Volume 48, Issue 2, Page(s) 153–177

Abstract: Evidence on the feasibility, effectiveness, and cost-effectiveness of integrating family planning (FP) and HIV services has grown significantly since the 2004 Glion Call to Action. This systematic review adds to the knowledge base by characterizing the ... ...

Abstract	Evidence on the feasibility, effectiveness, and cost-effectiveness of integrating family planning (FP) and HIV services has grown significantly since the 2004 Glion Call to Action. This systematic review adds to the knowledge base by characterizing the range of models used to integrate FP into HIV care and treatment, and synthesizing the evidence on integration outcomes among women living with HIV. Fourteen studies met our inclusion criteria, eight of which were published after the last systematic review on the topic in 2013. Overall, integration was associated with higher modern method contraceptive prevalence and knowledge, although there was insufficient evidence to evaluate its effects on unintended pregnancy or achieving safe and healthy pregnancy. Evidence for change in unmet need for FP was limited, although two of the three evaluations that measured unmet need suggested possible improvements associated with integrated services. However, improving access to FP services through integration was not always sufficient to increase the use of more effective (noncondom) modern methods among women who wanted to prevent pregnancy. Integration efforts, particularly in contexts where contraceptive use is low, must address community-wide and HIV-specific barriers to using effective FP methods alongside improving access to information, commodities, and services within routine HIV care.
MeSH term(s)	Ambulatory Care Facilities/organization & administration ; Contraception Behavior/statistics & numerical data ; Cost-Benefit Analysis ; Counseling ; Family Planning Services/economics ; Family Planning Services/organization & administration ; Family Planning Services/standards ; Female ; HIV Infections/therapy ; Health Knowledge, Attitudes, Practice ; Humans ; Inservice Training ; Patient Satisfaction ; Pregnancy ; Pregnancy, Unplanned ; Quality of Health Care ; Sex Education
Language	English
Publishing date	2017-03-24
Publishing country	United States
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	862445-8
ISSN	1728-4465 ; 0039-3665
ISSN (online)	1728-4465
ISSN	0039-3665
DOI	10.1111/sifp.12018
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Article ; Online: Psychosocial Syndemic Classes and Longitudinal Transition Patterns Among Sexual Minority men Living with or Without HIV in the Multicenter AIDS Cohort Study (MACS).

Liu, Yiyang / Ramos, Stephen D / Hanna, David B / Jones, Deborah L / Lazar, Jason M / Kizer, Jorge R / Cohen, Mardge H / Haberlen, Sabina A / Adimora, Adaora A / Lahiri, Cecile D / Wise, Jenni M / Friedman, Mackey R / Plankey, Michael / Chichetto, Natalie E

AIDS and behavior

2023 Volume 27, Issue 12, Page(s) 4094–4105

Abstract: Mental health and substance use epidemics interact to create psychosocial syndemics, accelerating poor health outcomes. Using latent class and latent transition analyses, we identified psychosocial syndemic phenotypes and their longitudinal transition ... ...

Abstract	Mental health and substance use epidemics interact to create psychosocial syndemics, accelerating poor health outcomes. Using latent class and latent transition analyses, we identified psychosocial syndemic phenotypes and their longitudinal transition pathways among sexual minority men (SMM) in the Multicenter AIDS Cohort Study (MACS, n = 3,384, mean age 44, 29% non-Hispanic Black, 51% with HIV). Self-reported depressive symptoms and substance use indices (i.e., smoking, hazardous drinking, marijuana, stimulant, and popper use) at the index visit, 3-year and 6-year follow-up were used to model psychosocial syndemics. Four latent classes were identified: "poly-behavioral" (19.4%), "smoking and depression" (21.7%), "illicit drug use" (13.8%), and "no conditions" (45.1%). Across all classes, over 80% of SMM remained in that same class over the follow-ups. SMM who experienced certain psychosocial clusters (e.g., illicit drug use) were less likely to transition to a less complex class. These people could benefit from targeted public health intervention and greater access to treatment resources.
MeSH term(s)	Male ; Humans ; Adult ; Sexual Behavior/psychology ; Acquired Immunodeficiency Syndrome/epidemiology ; Syndemic ; HIV Infections/psychology ; Cohort Studies ; Sexual and Gender Minorities ; Substance-Related Disorders/epidemiology ; Illicit Drugs ; Homosexuality, Male/psychology
Chemical Substances	Illicit Drugs
Language	English
Publishing date	2023-07-07
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	1339885-4
ISSN	1573-3254 ; 1090-7165
ISSN (online)	1573-3254
ISSN	1090-7165
DOI	10.1007/s10461-023-04123-y
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