Adverse Childhood Experiences, Smoking and Alcohol Use, and Allostatic Load Among People Living with HIV

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...

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Bibliographic Details
Published in:AIDS and behavior 2020-06, Vol.24 (6), p.1653-1662
Main Authors: Wallace, Maeve, Felker-Kantor, Erica, Madkour, Aubrey, Ferguson, Tekeda, Welsh, David, Molina, Patricia, Theall, Katherine P.
Format: Article
Language:English
Subjects:
Adverse childhood experiences
Alcohol use
Alcohols
Childhood
Childhood factors
Children
Health Psychology
HIV
Human immunodeficiency virus
Infectious Diseases
Medicine
Medicine & Public Health
Original Paper
Public Health
Smoking
Stress
Vulnerability
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Summary: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.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-019-02684-5