Associations between mental health indicators and genital immune biomarkers among recent survivors of forced sex: A case-control analysis

Katherine M. Anderson, Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States.
Jamila K. Stockman, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States. Electronic address: jstockman@ucsd.edu.
Eleanor Capozzi, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.
Stephanie A. Meyers-Pantele, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States.
Maile Y. Karris, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States.
Fernando Cabezas Mejia, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.
Ella Meyer, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.
Melodie A. Nasr, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.
Mimi Ghosh, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.

Document Type

Journal Article

Publication Date

1-1-2026

Journal

Psychoneuroendocrinology

Volume

183

DOI

10.1016/j.psyneuen.2025.107662

Keywords

Cisgender women; HIV prevention; Hypothalamic-pituitary-adrenal axis; Mucosal immunity; Sexual violence

Abstract

Sexual violence against women remains pervasive and is associated with HIV risk through sexual violence-related immune dysregulation. We sought to test the associations between mental health indicators and genital immune biomarkers among female survivors of recent sexual violence. Data were drawn from a case-control study of women in San Diego, California who had experienced recent forced or consensual vaginal penetration. Successive adjusted linear regressions models with interaction terms were employed to test moderation of the associations between mental health indicators (perceived stress, depression, PTSD symptoms, and resilience) and inflammatory (interleukin [IL]-1α, IL-1β, IL-6, IL-8, tumor necrosis factor-alpha [TNF-α], macrophage inflammatory protein-3α [MIP3α]), anti-inflammatory/anti-HIV (secretory leukocyte protease inhibitor (SLPI), elafin, and human β-defensin 2 [HBD2]) biomarkers, and percent HIV inhibition, by case/control status. Subsequently, stratified or non-stratified regressions were reported. Overall, participants (n = 64) identified as Hispanic (42.1 %), White (34.4 %), and Black (25.0 %), with a median age of 22 (IQR:18-26). Case participants had higher perceived stress, depression, PTSD symptoms, TNF-α, and SLPI. Analyses indicate differential relationships between cases and controls relating to IL1-α, IL-6, and IL-8, overall suggesting dysregulation of the immune response in cases compared to controls. Results point to a mechanism by which HIV/STI risk can increase in recent sexual violence survivors experiencing PTSD symptoms. Responsively, we suggest biological and behavioral intervention to limit lasting impacts of related trauma.

Department

Epidemiology

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