Mental Health, Mucosal Immunity, and HIV Susceptibility Following Sexual Violence: Evidence from the THRIVE Study

Sexual violence against women is a global issue with profound health consequences, including elevated HIV risk due to genital tract inflammation and injury. However, limited research has examined the influence of mental health on HIV-related immunity after violence. We analyzed longitudinal data from female survivors of past-month rape (N = 25) to explore associations between mental health (perceived stress, depression, post-traumatic stress disorder [PTSD], and resilience) and HIV-associated immune biomarkers in the female genital tract. In bivariate analyses, mental health improved over the three-month follow-up period. Immune biomarker levels remained largely stable, except for TNF-α and SLPI. At baseline, depression was significantly correlated with TNF-α, IL-6, and IL-1β. In regression analyses, depression was associated with TNF-α (β = -0.133 to -0.152) and IL-6 (β = -0.171 to -0.207). PTSD was significantly associated with IL-1α (β = 0.576 to 1.681). Depression and resilience were negatively associated with percent HIV inhibition in adjusted models. These findings suggest that depression and PTSD are associated with genital tract inflammation following sexual violence, which may compromise mucosal immunity and enhance HIV risk. This highlights the importance of integrated mental health and immunological care for survivors and the need for further research into psychoneuroimmune pathways influencing HIV risk after trauma.