Associations between mental health indicators and genital immune biomarkers among recent survivors of forced sex: A case-control analysis.

Sexual violence against women remains pervasive and is associated with HIV risk through sexual violence-related immune dysregulation. We sought to test the associations between mental health indicators and genital immune biomarkers among female survivors of recent sexual violence. Data were drawn from a case-control study of women in San Diego, California who had experienced recent forced or consensual vaginal penetration. Successive adjusted linear regressions models with interaction terms were employed to test moderation of the associations between mental health indicators (perceived stress, depression, PTSD symptoms, and resilience) and inflammatory (interleukin [IL]-1α, IL-1β, IL-6, IL-8, tumor necrosis factor-alpha [TNF-α], macrophage inflammatory protein-3α [MIP3α]), anti-inflammatory/anti-HIV (secretory leukocyte protease inhibitor (SLPI), elafin, and human β-defensin 2 [HBD2]) biomarkers, and percent HIV inhibition, by case/control status. Subsequently, stratified or non-stratified regressions were reported. Overall, participants (n = 64) identified as Hispanic (42.1 %), White (34.4 %), and Black (25.0 %), with a median age of 22 (IQR:18-26). Case participants had higher perceived stress, depression, PTSD symptoms, TNF-α, and SLPI. Analyses indicate differential relationships between cases and controls relating to IL1-α, IL-6, and IL-8, overall suggesting dysregulation of the immune response in cases compared to controls. Results point to a mechanism by which HIV/STI risk can increase in recent sexual violence survivors experiencing PTSD symptoms. Responsively, we suggest biological and behavioral intervention to limit lasting impacts of related trauma.