# The impact of childhood maltreatment, HIV status, and their interaction on mental health outcomes and markers of systemic inflammation in women

## TL;DR

Childhood trauma is linked to worse mental health and inflammation in women, regardless of HIV status, highlighting the need for trauma-informed care.

## Contribution

The study reveals that childhood maltreatment independently affects mental health and inflammation markers in women, regardless of HIV status.

## Key findings

- Women with higher childhood maltreatment had more severe PTSD and depression symptoms.
- Childhood maltreatment was associated with elevated lipopolysaccharide (LPS) levels in the blood.
- HIV status had no significant effect on mental health or inflammation markers in this study.

## Abstract

Childhood maltreatment and HIV are both associated with a greater risk for adverse mental health, including posttraumatic stress disorder (PTSD), depression, and increased systemic inflammation. However, it remains unknown whether childhood maltreatment and HIV interact to exacerbate PTSD, depression, and inflammation in a manner that may further increase the risk of adverse health outcomes in people living with HIV. This study investigated the interaction between childhood maltreatment and HIV status on PTSD and depression symptom severity, and on peripheral concentrations of lipopolysaccharide (LPS) and high sensitivity C-reactive protein (hsCRP) in women. We hypothesized that women living with HIV (WLWH) who report high levels of childhood maltreatment exposure would show the greatest PTSD and depressive symptoms, as well as the highest concentrations of LPS and hsCRP.

We conducted a cross-sectional study of 116 women (73 WLWH and 43 women without HIV). Participants completed interviews to measure trauma exposure, including childhood maltreatment, and PTSD and depression symptoms. They also provided blood samples that were analyzed for LPS and hsCRP concentrations.

Both women living with and without HIV reported high rates of trauma exposure and showed no statistically significant differences in overall rates of childhood maltreatment. Moderate to severe childhood maltreatment was associated with higher PTSD symptom severity (p =.005), greater depression severity (p =.005), and elevated plasma LPS concentrations (p =.045), regardless of HIV status. There were no effects of childhood maltreatment on hsCRP concentrations. There were no detectable significant effects of HIV status, or interactions between HIV status and childhood maltreatment, on PTSD and depression symptoms, or LPS and hsCRP concentrations (all p’s > 0.05).

Our findings highlight the impact of childhood maltreatment on depression and PTSD symptoms and LPS concentrations in women. These results underscore the importance of trauma-informed health care in addressing childhood maltreatment to potentially improve both mental and physical health outcomes of adult women.

Women with higher levels of childhood maltreatment show greater PTSD and depression symptoms.

Greater childhood maltreatment was associated with elevated circulating lipopolysaccharide (LPS) levels.

Both women living with and without HIV showed markedly elevated C-reactive protein.

Results underscore the importance of considering both psychological and physiological consequences of childhood trauma in women’s health.

Women living with HIV often face many challenges, including experiences of trauma and mental health issues. Our study looked at how childhood trauma and HIV status affect mental health and inflammation in women. We studied two groups of women: those living with HIV and those without HIV. Both groups included women who had experienced different levels of childhood trauma. We measured symptoms of depression and posttraumatic stress disorder (PTSD), as well as markers of inflammation in their blood.

We found that women who experienced more severe childhood trauma had more depression and PTSD symptoms, regardless of whether they had HIV or not. We also found higher levels of a gut-derived inflammatory marker in women who experienced more childhood trauma. Interestingly, most women with HIV in our study had well-controlled infection and HIV status itself didn’t make as much difference as we expected. This might be because both groups of women faced similar challenges, including limited access to resources and other health problems that can cause inflammation.

Our findings suggest that healthcare providers should pay attention to childhood trauma when treating women, whether they have HIV or not. This is particularly important for women from underserved communities who may face multiple health and socioeconomic challenges.