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The Role of Intersectional Stigma in Coronary Artery Disease Among Cisgender Women Aging with HIV.

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Title: The Role of Intersectional Stigma in Coronary Artery Disease Among Cisgender Women Aging with HIV.
Authors: Glynn, Tiffany R., Larson, Michaela E., Bernal, Maria, Satish, Sanjana, O'Reilly, Carolina Cruzval, Nogueira, Nicholas Fonseca, Zetina, Ana Salazar, Hurtado, Vanessa, Inestroza, Karla, Kedia, Sapna, Vilchez, Lilliana, Lang, Barbara, Valls, Priscilla, Siegel, Yoel, Schettino, Chris, Ghersin, Eduard, Pallikkuth, Suresh, Roach, Margaret, Pahwa, Savita, Mendez, Armando
Source: Behavioral Medicine. Jul-Sep2025, Vol. 51 Issue 3, p221-232. 12p.
Subjects: Psychological resilience, Risk assessment, Cross-sectional method, Research funding, Blood vessels, Computed tomography, Interviewing, Psychology of women, Cardiovascular diseases risk factors, Psychology of HIV-positive persons, Cisgender people, Aging, Coronary artery disease, Machine learning, Inflammation, Psychoneuroimmunology, Coronary artery calcification, Social stigma, Biomarkers, Coronary artery stenosis, Disease risk factors
Abstract: Cisgender women living with HIV experience elevated cardiovascular disease (CVD) risk that increases with age, a concern given extended life expectancies for people living with HIV. The CVD risk disparity among cisgender women aging with HIV is understudied and remains unclear. Taking a psychoneuroimmunology approach, given this group's intersecting marginalized identities, one potential driver of the disparity is intersectional stigma. Yet not all women living with HIV have coronary artery disease (CAD). Resilience to stigma may serve as a protective factor to CAD, as observed in other health issues. This study aimed to explore the relationship between intersectional stigma, resilience, "traditional" CVD risk factors, and objective indicators of CAD among women aging with HIV. A diverse sample of cisgender women aging with HIV (aged ≥ 35, N = 48) completed a cross-sectional survey, clinical health interview, blood sample, blood pressure, anthropometric measurements, and computed tomography angiography (CTA). CART-based machine learning models assessed the statistical importance of traditional CVD risk factors, intersectional stigma, and resilience for classifying individuals with coronary artery stenosis, calcification, and inflammatory markers associated with CAD. Of the n = 31 who completed CTA, 74% had detectable calcification and 39% stenosis. Intersectional stigma was identified as an important variable for explaining calcification, but not stenosis, and for explaining sCD163, an inflammatory biomarker associated with CAD. Results show a potential psychoneuroimmunology pathway to the CAD disparity among this group. Future longitudinal research should investigate the mechanisms of this pathway and consider stigma as target for intervention to improve cardiovascular health among women aging with HIV. [ABSTRACT FROM AUTHOR]
Copyright of Behavioral Medicine is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The Role of Intersectional Stigma in Coronary Artery Disease Among Cisgender Women Aging with HIV.
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  Data: <searchLink fieldCode="JN" term="%22Behavioral+Medicine%22">Behavioral Medicine</searchLink>. Jul-Sep2025, Vol. 51 Issue 3, p221-232. 12p.
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  Data: Cisgender women living with HIV experience elevated cardiovascular disease (CVD) risk that increases with age, a concern given extended life expectancies for people living with HIV. The CVD risk disparity among cisgender women aging with HIV is understudied and remains unclear. Taking a psychoneuroimmunology approach, given this group's intersecting marginalized identities, one potential driver of the disparity is intersectional stigma. Yet not all women living with HIV have coronary artery disease (CAD). Resilience to stigma may serve as a protective factor to CAD, as observed in other health issues. This study aimed to explore the relationship between intersectional stigma, resilience, "traditional" CVD risk factors, and objective indicators of CAD among women aging with HIV. A diverse sample of cisgender women aging with HIV (aged ≥ 35, N = 48) completed a cross-sectional survey, clinical health interview, blood sample, blood pressure, anthropometric measurements, and computed tomography angiography (CTA). CART-based machine learning models assessed the statistical importance of traditional CVD risk factors, intersectional stigma, and resilience for classifying individuals with coronary artery stenosis, calcification, and inflammatory markers associated with CAD. Of the n = 31 who completed CTA, 74% had detectable calcification and 39% stenosis. Intersectional stigma was identified as an important variable for explaining calcification, but not stenosis, and for explaining sCD163, an inflammatory biomarker associated with CAD. Results show a potential psychoneuroimmunology pathway to the CAD disparity among this group. Future longitudinal research should investigate the mechanisms of this pathway and consider stigma as target for intervention to improve cardiovascular health among women aging with HIV. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Behavioral Medicine is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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        Value: 10.1080/08964289.2024.2429073
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        Text: English
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      – SubjectFull: Psychological resilience
        Type: general
      – SubjectFull: Risk assessment
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      – SubjectFull: Cross-sectional method
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      – SubjectFull: Research funding
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      – SubjectFull: Interviewing
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      – SubjectFull: Coronary artery disease
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