Publications by authors named "Plankey M"

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.

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Article Synopsis
  • - The 14th International Workshop on HIV and Aging, held on October 26-27, 2023, focused on improving health span for people living with HIV (PWH) by exploring issues related to aging and comorbid conditions.
  • - Key topics included the biology and treatment of sarcopenia, long-acting antiretroviral therapy (ART), and complications related to the central nervous system, along with mental health and social factors.
  • - Presentations emphasized the need for prioritizing mental health care, addressing loneliness, and conducting research on resilience among PWH to tackle ongoing challenges.
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  • 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
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Partnership status among sexual minority men (SMM) is a potentially important yet underexplored predictor of cognitive functioning. Using data from the understanding patterns of healthy aging among men who have sex with men substudy of the Multicenter AIDS Cohort Study, we assessed the associations of partnership status and quality with cognitive performance in middle-aged and older SMM, adjusting for sociodemographic and clinical covariates. Partnership status was classified into four types: "only a primary partnership," "only a secondary partnership," "both a primary and secondary relationship," and "neither a primary nor secondary relationship.

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Interpersonal management of homophobic stigma (e.g., selectively constructing one's social network; confronting stigma) is an understudied area of resilience among sexual minority people.

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Sexual minority men (SMM) in the US are twice as likely to experience mental health challenges, including depressive symptoms, compared with their heterosexual counterparts. Having a like-mentor, or a sexual minority mentor, is associated with improved mental well-being among SMM mentees. However, few studies have explored the potential benefits to mentors.

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  • The study aimed to explore the health outcomes of women with HIV who have low-level viremia (LLV), focusing on virologic failure and the development of non-AIDS comorbidities.
  • Researchers analyzed data from the Women's Interagency HIV Study, categorizing women based on their viral load status into groups: virologic suppression, intermittent LLV, persistent LLV, and virologic failure.
  • Results indicated that women with intermittent or persistent LLV had a higher risk of virologic failure compared to those with virologic suppression, with persistent LLV showing a tendency towards increased risk for multiple health issues.
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Existing studies examining resilience among sexual minority men (SMM) have been limited by only analyzing 1 level of resilience. We therefore investigated the impact of multiple levels of resilience on the bidirectional relationship between loneliness and depression symptoms among older SMM. Loneliness, depression symptoms, and multilevel resilience scores were collected across 3 time points (October 2016 to March 2017 [T1]; October 2017 to March 2018 [T2]; and October 2018 to March 2019 [T3]) among 1,264 SMM aged 40 years and older living with and without HIV.

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Aging gay and bisexual men may have negative self-image due to body image dissatisfaction and internalized ageism, resulting in psychological distress. Gay and bisexual men with HIV may be at greater risk for distress because of research linking HIV to accelerated aging. We examined associations between self-image and psychological distress, and potential mediating effects resilience, fitness engagement, and whether these relationships were moderated by HIV serostatus.

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Purpose: To investigate vision impairment as a barrier to engagement in medical care among aging persons living with HIV (PLWH) who experience multimorbidity and complex care needs.

Setting: Multicenter AIDS Cohort Study (MACS), a prospective observational cohort of aging PLWH men.

Methods: We examined relationships of self-reported vision difficulty with indicators of care engagement: 1) adherence to HIV antiretroviral therapy (ART; defined as taking ≥95% of medications); 2) self-reported avoidance of medical care; 3) self-reported tendency to ask a doctor questions about care (>2 questions at a medical visit), as well as with quality of life.

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Men who have sex with men (MSM) are at increased risk for certain types of chronic diseases and mental health problems. Despite having extended survival in the highly active antiretroviral therapy (HAART) era, MSM living with HIV contend with aging-related diseases and complications with treatment. Consequent hospitalizations incur high costs, fear, low quality of life, and frailty.

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Background: Steatohepatitis is common in persons living with HIV and may be associated with gut microbial translocation (MT). However, few studies have evaluated the gut-liver axis in persons living with HIV. In the Women's Interagency HIV Study, we examined the associations of HIV and circulating biomarkers linked to MT and gut damage using the FibroScan-aspartate aminotransferase (FAST) score, a noninvasive surrogate for steatohepatitis with advanced fibrosis.

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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.

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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.

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Background: People living with HIV (PLWH) have greater risk for arrhythmic sudden death and heart failure than people without HIV (PWOH), though risk identifiers remain understudied. Higher ventricular ectopy (VE) burden reflects increased arrhythmic susceptibility and cardiomyopathy risk.

Objectives: The purpose of this study was to test if myocardial scar measured by late gadolinium-enhancement cardiovascular magnetic resonance (LGE-CMR) associates with VE by ambulatory electrocardiographic monitoring among PLWH and PWOH with risk factors for HIV, and if the association differs by HIV.

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Introduction: Erectile dysfunction (ED) has been established as a comorbidity among men living with HIV, but comparisons by HIV serostatus of ED incidence in a longitudinal follow-up cohort of men are lacking. We sought to evaluate the incidence of ED spanning a period of 12 years in a longitudinal cohort of sexual minority men (SMM) living with and without HIV.

Methods: We analyzed ED incidence data for 625 participants in the longitudinal Multicenter AIDS Cohort Study from visits spanning October 2006 to April 2019.

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Background: Frailty is a clinical, geriatric syndrome linked to disability and mortality; and may be associated with a variety of factors among underrepresented and underserved women living with HIV (WLWH) and without HIV (WLWOH) transitioning through the adult life course.

Objectives: Determine whether a published set of factors associated cross-sectionally with frailty in WLWH and similar WLWOH at average age 39 years in 2005/2006 were associated with frailty in 2018/2019 among women who initiated frailty assessments at age ≥40 years, or whether a new set of factors were associated with frailty.

Design: Cross-sectional analyses within a longitudinal cohort study.

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Article Synopsis
  • The study examines the relationship between HIV, androgen hormone levels, SHBG, menopausal phase, and diabetes risk in women, comparing those with HIV to those without.
  • It found that while both groups showed similar diabetes rates, higher levels of SHBG and DHEAS were associated with slower progression to diabetes, particularly in women without HIV.
  • The results suggest that the menopausal transition might be a more important indicator of diabetes risk for women living with HIV than hormone levels alone.
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  • 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.
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Background And Objectives: Loneliness is associated with frailty among older adults (60+), and there is evidence suggesting that this association may be bidirectional. However, there is limited evidence of this relationship over time among middle-aged and aging sexual minority men. We explored the bidirectional relationship between loneliness and frailty over 2 years among sexual minority men living with or without human immunodeficiency virus (HIV) from the Healthy Aging substudy of the Multicenter AIDS Cohort Study.

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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.

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Rates of cigarette smoking in people with HIV (PWH) are two to three times higher than in people without HIV. Nicotine is metabolized by CYP2A6 and the nicotine metabolite ratio (NMR; 3-hydroxycotinine/cotinine) is a measure of nicotine clearance. Higher NMR has been observed in PWH and is associated with lower quit rates.

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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.

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Background And Objective: Observations of overweight and obesity in association with neuropsychological performance (NP) vary over the adult life course depending on baseline levels, biological sex, age, race, temporality of measurements, and other factors. Therefore, similar published analyses across cohorts are inconsistent. In our sample of women living with HIV (WLWH) and women without HIV (WWOH), we conducted comparable analyses as those published in men with and without HIV.

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