Gender-Based Violence, Physiological Stress, and Inflammation: A Cross-Sectional Study

Area of Science:

• Public Health
• Endocrinology
• Sociomedical Sciences

Background:

• Female sex workers (FSWs) face elevated risks of gender-based violence (GBV) and HIV infection.
• Understanding the physiological impact of GBV is crucial for mitigating HIV risk in this population.

Purpose of the Study:

• To investigate the association between recent GBV exposure and biomarkers of physiological stress and inflammation.
• To explore the potential role of these biomarkers in the increased HIV risk among Kenyan FSWs.

Main Methods:

• A cohort of 283 Kenyan FSWs completed questionnaires on GBV exposure and mental health.
• Plasma samples were analyzed for C-reactive protein (CRP) and interleukin-6 (IL-6) levels.
• Hair samples were analyzed for cortisol concentration to assess chronic stress.

Main Results:

• No significant differences in CRP or IL-6 levels were observed across GBV exposure groups.
• Women reporting recent GBV exposure exhibited significantly higher hair cortisol concentrations compared to those with remote or no exposure.
• Multivariable regression confirmed a positive association between recent GBV and elevated hair cortisol.

Conclusions:

• While inflammation markers (CRP, IL-6) were not associated with GBV, recent GBV significantly increased hair cortisol levels.
• Elevated cortisol due to GBV may influence health outcomes and warrants further investigation regarding HIV acquisition risk.