Open AccessAdverse Childhood Experiences, Smoking and Alcohol Use, and Allostatic Load Among People Living with HIV
Author(s) -
Maeve Wallace,
Erica Felker-Kantor,
Aubrey Spriggs Madkour,
Tekeda Ferguson,
David A. Welsh,
Patricia E. Molina,
Katherine P. Theall
Publication year - 2019
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-019-02684-5
Subject(s) - allostatic load , stressor , allostasis , health psychology , adverse childhood experiences , coping (psychology) , mediation , medicine , public health , psychology , gerontology , environmental health , clinical psychology , psychiatry , mental health , immunology , nursing , political science , law
Allostatic load is an indicator of multisystem physiologic dysregulation that may arise from prolonged or accumulated exposure to stress, including adverse childhood experiences (ACEs) and chronic stressors persisting into adulthood. People living with HIV (PLWH) may be particularly vulnerable given their high burdens of adversity across the life course. Using data from a cohort of middle aged PLWH, we examined associations between ACEs and two measures of allostatic load. In order to determine whether the negative impact of ACEs on allostatic load operates through increasing the adoption of adverse coping behaviors, we tested for mediation by smoking and alcohol use. PLWH who had experienced 4 or more ACEs had on average higher allostatic load in adulthood compared to those who experienced fewer. Neither smoking nor alcohol use mediated this relationship, however, suggesting alternative mechanisms may be at play.