Longitudinal assessment of changes in hair cortisol levels and associations with violence, poor mental health and harmful substance use among female sex workers in Nairobi, Kenya
Dados Bibliográficos
Female sex workers (FSWs) in sub-Saharan Africa commonly experience violence, mental health problems, and harmful substance use. Stressful life events can harm the functioning of the hypothalamic-pituitary-adrenal (HPA) axis, serving as a pathway to increased poor health, including HIV susceptibility through cortisol levels. In this paper, we examine changes in hair cortisol concentration (HCC) levels and associations with experiences of violence, mental health problems and harmful substance use among FSWs in Nairobi, Kenya. We used baseline and endline data from the Maisha Fiti study of FSWs in Nairobi. Participants reported recent violence, poor mental health, and harmful alcohol/substance use at both time points. Hair samples proximal to the scalp were collected to measure HCC levels determined by ELISA technique. We analysed data from 285 HIV-negative respondents who provided a 2 cm hair sample at baseline and endline. Multivariable linear regression models were used to assess the associations between the trajectory of the main exposure variables and the change in HCC levels at endline. Findings showed that HCC levels decreased significantly (p-value = 0.001) from baseline (mean HCC = 316 ng/g) to endline (mean HCC = 238.1 ng/g). Reported prevalence of violence, mental health problems and harmful alcohol/other substances decreased. There was evidence of associations between change in HCC at endline and the trajectories of physical violence (p-value = 0.007) and physical and/or sexual violence (p-value = 0.048). There was weak evidence of an association between the trajectory of exposure to emotional violence but no evidence of other associations. These findings suggest that physical violence and physical and/or sexual violence may lead to HPA axis dysfunction, possibly serving as a pathway linking violence to increased poor health, including HIV acquisition. However, further research with repeated measurements and a larger sample size is needed to examine the associations between violence, HCC levels, and HIV infection
Longitudinal study · Mental health · Occupational safety and health · Physical abuse · Poison control · Psychological abuse · Sex work · Sexual abuse · Substance abuse · Adolescent Sexual and Reproductive Health · Sex work and related issues · Stress Responses and Cortisol
The concept of allostasis in biology and biomedicine
Mental health and HIV/Aids
Hair cortisol, stress exposure, and mental health in humans
Intimate partner violence and HIV in ten sub-Saharan African countries
Associations between sex work laws and sex workers’ health
Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk
Intimate partner violence and HIV infection among women
Forced Sexual Initiation, Sexual Intimate Partner Violence and HIV Risk in Women
Socio-Demographic Characteristics and Behavioral Risk Factors of Female Sex Workers in Sub-Saharan Africa
Global epidemiology of HIV among female sex workers
The Global Prevalence of Intimate Partner Violence Against Women
Longitudinal experiences and risk factors for common mental health problems and suicidal behaviours among female sex workers in Nairobi, Kenya
Surviving pandemic control measures
Harmful Alcohol and Drug Use Is Associated with Syndemic Risk Factors among Female Sex Workers in Nairobi, Kenya
Violence across the Life Course and Implications for Intervention Design
Relationship between mobility, violence and HIV/STI among female sex workers in Andhra Pradesh, India
Beaten but not down! Exploring resilience among female sex workers (FSWs) in Nairobi, Kenya
The Relationship of Trauma to Mental Disorders Among Trafficked and Sexually Exploited Girls and Women
Methods for the Scientific Study of Discrimination and Health
If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans
| Velocidade de citação | historical |
|---|---|
| Altamente citado | Não |