Abstract
Persons living with HIV (PWH) face psychosocial stressors like stigma and discrimination, leading to social exclusion. They are at increased risk for cardiovascular disease and may experience changes in brain regions involved in cardiovascular responses to stress. This study compared the blood oxygen level-dependent (BOLD) response to social exclusion versus inclusion during the Cyberball task in HIV-positive and HIV-negative individuals, alongside cardio-autonomic responses.
We examined whether systolic and diastolic blood pressure (SBP and DBP) and heart rate variability (HRV), measured by RMSSD and SDNN, predicted BOLD responses in regions of interest (ROIs) like the ventromedial prefrontal cortex (vmPFC), ventral anterior cingulate cortex (vACC), and anterior insula, and whether these relationships differed by HIV status.
Using a three-level HLM approach, we explored the contributions of individual variables (age, gender, discrimination), ROIs, and interaction effects on cardiovascular outcomes. We found that greater BOLD activation in the vmPFC was negatively associated with SBP (b= -0.775, t= -3.17, p= .005), RMSSD (b= -1.16, t= -4.49, p< .001), and SDNN (b= -0.69, t= -2.58, p=.016). Activation in the vACC was positively associated with RMSSD (b= 0.81, t=3.06, p=.005) and SDNN (b= .82, t= 2.98, p= .006). These effects remained largely unchanged after accounting for HIV status.
However, HIV status moderated the relationship between activation in the vmPFC and left anterior insula with RMSSD, with the effects being lower in PWH. Understanding these responses could lead to interventions aimed at improving the psychological well-being and social functioning of PWH.