Publications by authors named "MH Cohen"
Background: The HIV-1 reservoir in CD4+ T cells (HR) pose a major challenge to curing HIV, with many of its mechanisms still unclear. HIV-1 DNA integration and immune responses may alter the host's epigenetic landscape, potentially silencing HIV-1 replication.
Methods: This study used bisulphite capture DNA methylation sequencing in CD4+ T cells from the blood of 427 virally suppressed women with HIV to identify differentially methylated sites and regions associated with HR.
Background: Black women living with HIV (WLHIV) often have suboptimal ART adherence due to a multitude of social and structural barriers, including HIV-related stigma. Trust in healthcare providers plays a significant role in adhering to ART and is likely lower among Black WLHIV compared to their White counterparts. This study examined the relationship between experienced stigma in healthcare settings and ART adherence and viral suppression through anticipated stigma in healthcare settings, internalized stigma, and medical mistrust.
View Article and Find Full Text PDFBackground: Depression affects 33% of women with type 2 diabetes (T2D) and leads to increased risks of premature mortality. Fluctuation and variation of depressive presentations can hinder clinical identification.
Purpose: We aimed to identify and examine subgroups characterized by distinct depressive symptom trajectories among women with T2D.
Background: Heavy drinking, smoking, and depression are common among men who have sex with men (MSM). The association of co-occurring longitudinal patterns of these conditions and mortality among MSM were tested, applying a syndemic framework - the interaction of two or more conditions that contribute to poor health outcomes.
Methods: Longitudinal data from 1999 to 2018 from the Multicenter AIDS Cohort Study of 3046 MSM were analyzed.
Article Synopsis
- The research investigates the co-utilization of HIV care, substance use (SU) treatment, and mental health services among women at risk for or living with HIV, highlighting the impact of a syndemic involving HIV, substance use, and mental illness.
- Data from 2,559 women enrolled in the Women's Interagency HIV Study (WIHS) were analyzed to assess service utilization, revealing that while 84% of women with both HIV and current SU saw their HIV provider, only a small percentage engaged in alcohol (18%) and tobacco (8%) treatment.
- The study concludes that despite high engagement in HIV care, there is a significant gap in the uptake of alcohol and tobacco treatment, emphasizing the need for integrated services that address
Frequent Cocaine Use is Associated With Larger HIV Latent Reservoir Size.
J Acquir Immune Defic Syndr
October 2024
Article Synopsis
- Cocaine is a commonly abused drug among people living with HIV, negatively affecting their health by slowing down the decline of viral production after starting antiretroviral therapy and leading to higher viral loads and faster disease progression.
- The study focused on 434 women with varying ancestry participating in a national cohort study, analyzing the impact of cocaine use on the HIV latent reservoir in their CD4+ T-cells.
- Results showed that current and prior cocaine users have significantly larger HIV latent reservoir sizes compared to non-users, highlighting the need for more research on cocaine's effects on women's HIV outcomes.
Article Synopsis
- Telomere length (TL) is a key marker of cellular aging, with shorter TL linked to numerous age-related diseases, including various cancers and heart issues.
- The study used a DNA methylation-based estimator to assess TL and found that individuals with HIV had significantly shorter TL compared to those without HIV.
- Shorter TL was associated with higher cancer prevalence, increased physiologic frailty, and a notable 40% increased risk of mortality, indicating the serious health implications of reduced DNAmTL.
Article Synopsis
- A study aimed to identify specific DNA methylation patterns linked to HIV infection in various immune cell types like CD4+ T-cells, CD8+ T-cells, B cells, Natural Killer (NK) cells, and monocytes, rather than relying on bulk blood analysis.
- Researchers utilized a computational method to analyze DNA methylation in 1,382 samples across three cohorts and validated findings using advanced sequencing techniques.
- The results revealed 2,021 unique CpG sites associated with HIV in different cell types, with CD4+ T-cells showing the highest number of unique sites, indicating their significant role in immunity and HIV pathogenesis.
Article Synopsis
- The study examines the impact of parenting on youth health outcomes, particularly focusing on adolescents living with HIV transitioning from pediatric to adult care in Rwanda.
- It evaluated the Children's Report of Parenting Behavior Inventory (CRPBI) for both youth and caregivers, finding a two-dimensional factor structure: acceptance/positive involvement and hostile detachment/rejection.
- While the CRPBI was reliable and valid for youth responses, it was less effective for caregivers, indicating the need for careful adaptation of parenting assessment tools in different cultural contexts.
Article Synopsis
- The study investigates the link between sexual and physical abuse and cardiovascular disease (CVD) risk specifically in women living with HIV (WLWH) compared to women without HIV (WLWOH).
- Findings show that childhood and adulthood sexual abuse increase CVD risk in WLWH, while adulthood physical abuse also raises CVD risk for both groups, with childhood physical abuse showing no significant effect.
- The study identifies potential factors, such as depression and smoking, as pathways that may explain the relationship between abuse history and higher CVD risk in these women.
Article Synopsis
- Mental health issues and substance use interact, creating psychosocial syndemics that worsen health outcomes for sexual minority men (SMM).
- A study with 3,384 SMM identified four groups: "poly-behavioral," "smoking and depression," "illicit drug use," and "no conditions," with many remaining in their initial class over time.
- SMM experiencing complex issues, like illicit drug use, are less likely to improve and may require specialized public health interventions and better access to treatment resources.
Article Synopsis
- Heavy drinking, smoking, and depression are common among women with HIV, but the long-term effects of having multiple conditions at once on mortality are not well understood.
- This study analyzed data from over 3,000 women with HIV to investigate the relationship between these conditions and mortality risks, finding that nearly 17% had two or more conditions.
- Women with multiple risk factors had a significantly higher all-cause mortality risk (almost 4 times greater compared to those with none), highlighting the necessity for coordinated treatment and screening for these interconnected health issues.*
Article Synopsis
- - Women living with HIV (WLWH) often struggle with depression and are not well-researched in mental health studies; positive emotions could improve their health outcomes and should be included in psychological treatments.
- - A five-week, self-guided web-based program aimed at enhancing positive emotions was tested with 23 WLWH participants, showing successful engagement and completion of most activities.
- - Feedback indicated high acceptability of the program, with participants highly recommending it to others, suggesting it could be further developed and tested for effectiveness in improving mental health.
Article Synopsis
- - Persistent inflammation from HIV contributes to cardiovascular disease (CVD), driven notably by innate immune cells like monocytes, leading to this study's focus on the roles of non-classical and intermediate monocytes in this context.
- - The study assessed women with and without chronic HIV infection and subclinical CVD, using ultrasound to identify plaques, and compared gene expression in monocytes between those with different HIV/CVD statuses and healthy controls.
- - Findings revealed that while intermediate monocytes showed limited gene expression changes with HIV or CVD alone, coexisting conditions produced distinct gene signatures, which were eliminated with lipid-lowering treatment, and non-classical monocytes exhibited significant changes, especially in cases of comorbid HIV and CVD
Article Synopsis
- Polypharmacy, or the use of five or more medications, may lead to issues with sticking to prescribed treatments, particularly in women with HIV.
- A study analyzed data from the Women's Interagency HIV Study, focusing on adherence to antiretroviral therapy (ART) and patterns of polypharmacy among 1,538 women aged 18 and older.
- Results showed distinct patterns for adherence and polypharmacy, but the joint analysis found no significant relationship between the two, suggesting a need for further research using more precise measures of adherence.
Article Synopsis
- Food insecurity significantly impacts individuals with HIV and women in the US, highlighting its role in health outcomes and treatment adherence.
- The study utilized random effects models on data from the US Women’s Interagency HIV Study to evaluate how food security affects adherence to antiretroviral therapy (ART) and engagement in HIV care.
- Results indicated that very low food security correlates with greater risks of ART non-adherence and lower likelihood of consistent HIV care, emphasizing the need for addressing food insecurity to improve health outcomes in this population.
Article Synopsis
- Researchers used a computational method to conduct a cell-type-specific epigenome-wide association study (EWAS) on chronic HIV infection in various immune cells, identifying unique methylation patterns for different cell types.
- They found that a significant portion (67%) of differentially methylated CpG sites were unique to specific immune cell types, with CD4+ T-cells showing the highest number of associated sites (1,472).
- The genes linked to these CpG sites are involved in immune responses and cancer pathways, highlighting the potential relationship between HIV-induced epigenetic changes and increased cancer risk.
Article Synopsis
- * A study involving 1,437 women identified four adherence patterns: consistently high, moderate increasing, moderate decreasing, and consistently low, with 12% experiencing virologic failure.
- * Those with consistently low or moderately decreasing adherence were at significantly higher risk of virologic failure compared to those with consistently high adherence, highlighting the need for targeted interventions addressing these issues, especially around alcohol use and depression.
Article Synopsis
- Polypharmacy, defined as the use of five or more medications, can lead to difficulties in adhering to prescribed treatments, particularly in women with HIV.
- A study involving 1,538 women aged 18 and older analyzed their adherence to antiretroviral therapy (ART) and patterns of polypharmacy over a five-year period.
- The results did not show any significant link between adherence to ART and polypharmacy patterns, suggesting that further research using more precise measures of adherence is needed to explore this relationship.
Objective: Hypertension is a critical cause of cardiovascular disease, and women with HIV have a higher prevalence of hypertension than women without HIV. The relationship between hypertension and mortality has not been well characterized in women with treated HIV. Here, we estimate the effect of hypertension on 1-year risk of all-cause mortality among women with HIV on antiretroviral therapy (ART) in the United States.
View Article and Find Full Text PDFArticle Synopsis
- This study examined substance use (SU) and treatment among women living with HIV (WWH) and women without HIV in the Women's Interagency HIV Study (WIHS) from 2013 to 2020, finding that 14% reported current SU, with crack/cocaine being the most common substance used.
- Of the 367 women with current SU, 42% accessed treatment in the past year, primarily through methadone, but the study indicated that concurrent alcohol or marijuana use reduced the likelihood of seeking treatment among WWH.
- The findings emphasize the importance of improving access to SU treatment for WWH, suggesting a need to make treatments like buprenorphine more available and
Article Synopsis
- Resilience and optimism can positively affect health outcomes and buffer the negative impacts of stress, particularly for women living with HIV (WLHIV).
- A study with 1,405 WLHIV showed that higher stigma was linked to more depression and less trust in healthcare providers, but resilience and optimism lessened these negative effects.
- The research indicates that enhancing resilience and optimism could be effective strategies to reduce depression symptoms and improve trust in healthcare among those who experience stigma.
Internalized HIV-Related Stigma and Neurocognitive Functioning Among Women Living with HIV.
AIDS Patient Care STDS
September 2022
Article Synopsis
- * It utilizes a comprehensive set of tests to evaluate various cognitive domains, revealing that internalized stigma is linked to poorer performance in neurocognitive tasks.
- * Findings indicate that addressing internalized stigma could be key to improving cognitive health among WLWH, suggesting that further research is needed to explore the long-term effects and other forms of stigma on neurocognitive function.