Perceived stress and incident sexually transmitted infections in a prospective cohort.
Adolescent
Adult
Chlamydia Infections
/ epidemiology
Chlamydia trachomatis
/ isolation & purification
Female
Gonorrhea
/ epidemiology
Humans
Incidence
Longitudinal Studies
Microbiota
Neisseria gonorrhoeae
/ isolation & purification
Prospective Studies
Sexual Behavior
Sexual Partners
Sexually Transmitted Diseases
/ diagnosis
Stress, Psychological
/ complications
Trichomonas Infections
/ epidemiology
Trichomonas Vaginitis
/ epidemiology
Trichomonas vaginalis
Vagina
/ microbiology
Vaginosis, Bacterial
/ complications
Young Adult
Bacterial vaginosis
Chlamydia
Gonorrhea
Prospective studies
Psychological stress
Sexual behavior
Sexually transmitted diseases
Trichomonas
Journal
Annals of epidemiology
ISSN: 1873-2585
Titre abrégé: Ann Epidemiol
Pays: United States
ID NLM: 9100013
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
19
09
2018
revised:
02
12
2018
accepted:
15
01
2019
pubmed:
26
2
2019
medline:
3
1
2020
entrez:
26
2
2019
Statut:
ppublish
Résumé
Psychosocial stress has been associated with susceptibility to many infectious pathogens. We evaluated the association between perceived stress and incident sexually transmitted infections (STIs; Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis genital infections) in a prospective study of women. Stress may increase vulnerability to STIs by suppressing immune function and altering the protective vaginal microbiota. Using the 1999 Longitudinal Study of Vaginal Flora (n = 2439), a primarily African American cohort of women, we fitted Cox proportional hazards models to examine the association between perceived stress and incident STIs. We tested bacterial vaginosis (measured by Nugent Score) and sexual behaviors (condom use, number of partners, and partner concurrence) as mediators using VanderWeele's difference method. Baseline perceived stress was associated with incident STIs both before and after adjusting for confounders (adjusted hazard ratio = 1.015; 95% confidence interval, 1.005-1.026). Nugent score and sexual behaviors significantly mediated 21% and 65% of this adjusted association, respectively, and 78% when included together in the adjusted model. This study advances understanding of the relationship between perceived stress and STIs and identifies high-risk sexual behaviors and development of bacterial vaginosis-both known risk factors for STIs-as mechanisms underlying this association.
Identifiants
pubmed: 30799204
pii: S1047-2797(18)30884-6
doi: 10.1016/j.annepidem.2019.01.010
pmc: PMC6446572
mid: NIHMS1522375
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
20-27Subventions
Organisme : Intramural NIH HHS
ID : Z01 HD002535
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD041041
Pays : United States
Organisme : Intramural NIH HHS
ID : Z01 HD002535-09
Pays : United States
Organisme : Intramural NIH HHS
ID : Z01 HD002535-10
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI116799
Pays : United States
Organisme : NICHD NIH HHS
ID : N01 HD083293
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
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