Clinical indications for medicinal cannabis include chronic conditions; thus users (MCUs) are at an increased risk of morbidity and mortality resulting from SARS-CoV-2 infection (COVID-19). The stu...

Objective: Depression, substance use disorders, and other neuropsychiatric comorbidities are common in people with HIV (PWH), but the underlying mechanisms are not sufficiently understood. HIV-induced damage to the gastrointestinal tract potentiates residual immune dysregulation in PWH receiving effective antiretroviral therapy. However, few studies among PWH have examined the relevance of microbiome-gut-brain axis: bidirectional crosstalk between the gastrointestinal tract, immune system, and central nervous system. Methods: A narrative review was conducted to integrate findings from 159 articles relevant to psychoneuroimmunology (PNI) and microbiome-gut-brain axis research in PWH. Results: Early PNI studies demonstrated that neuroendocrine signaling via the hypothalamic-pituitary-adrenal axis and autonomic nervous system could partially account for the associations of psychological factors with clinical HIV progression. This review highlights the need for PNI studies examining the mechanistic relevance of the gut microbiota for residual immune dysregulation, tryptophan catabolism, and oxytocin release as key biological determinants of neuropsychiatric comorbidities in PWH (i.e., body-to-mind pathways). It also underscores the continued relevance of neuroendocrine signaling via the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and oxytocin release in modifying microbiome-gut-brain axis functioning (i.e., mind-to-body pathways). Conclusions: Advancing our understanding of PNI and microbiome-gut-brain axis pathways relevant to depression, substance use disorders, and other neuropsychiatric comorbidities in PWH can guide the development of novel biobehavioral interventions to optimize health outcomes. Recommendations are provided for biobehavioral and neurobehavioral research investigating bidirectional PNI and microbiome-gut-brain axis pathways among PWH in the modern antiretroviral therapy era.

The COVID-19 pandemic is a worldwide event that has exacerbated stress and caused significant disruptions in the day-to-day living of families. Of particular concern are socially vulnerable families, which have felt the impacts of the pandemic most acutely. Because stress can alter family dynamics, it is important to understand which stressors impact families the most, and what resources can be leveraged to strengthen family functioning. The current study examined the impacts of COVID-19 on the conflict and cohesion of households with children compared to households without children. Additionally, we sought to assess how conflict and cohesion are related to social vulnerabilities in the context of the pandemic. Using an international sample, we analyzed responses to the COVID-19 Household Environment Scale (N = 4122) using descriptive and bivariate analyses. Latent class analysis was used to identify patterns of family functioning in households with and without children. We found that social vulnerability was associated with more disrupted family functioning, and that households with children (n = 2666) reported less disrupted family functioning when compared to households without children (n = 1456), despite having higher social vulnerability scores. Our exploratory latent class analysis identified a 5-class model among both subgroups. Conflict, cohesion, family functioning and social vulnerability varied significantly by subgroup and class membership. Our findings add to a body of evidence that argues that despite facing greater vulnerability, households with children have many strengths to draw from. Family interventions that help to promote family cohesion and conflict resolution can foster resilience in stressful circumstances.

The syndemic theoretical framework has been used in health disparities research to explain several co-occurring epidemics, particularly in populations facing disparate health conditions. A prominent example of this is seen in Singer’s Substance Abuse, Violence and HIV/AIDS (SAVA) syndemic theory. However, even though numerous studies support some of the theoretical underpinnings of the SAVA syndemic, the empirical applications of the theory remain methodologically underdeveloped. The current review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR), to present the state of the science of methodologies examining SAVA constructs using the syndemic framework. Seven bibliographic databases were searched with no language or date restrictions. Studies were synthesized by author, year of publication, study location, total sample size, study population, SAVA outcomes, analytic method of SAVA measurement, intervention type, level of influence, disease interaction and concentration, main findings of the study, and possible future areas of research. Our search yielded a total of 967 articles, and 123 were included in the review. Methodologic and statistical innovation is needed to elevate the impact of syndemic theory for elucidating the synergistic effects of determinants leading to health disparities.

Introduction: The COVID-19 pandemic has dramatically altered the functioning of households. Because of the vulnerability of high-risk groups, such as older adults and people with compromised immune systems, households caring for these vulnerable adults may be facing elevated levels of caregiving-related stress and burden. The current study sought to examine the impact of the pandemic on conflict and cohesion in households with adults requiring caregiving versus noncaregiving households. Methods: Respondent demographic, household level, and family functioning data were collected anonymously from an international sample (N = 4,241). Responses were examined using descriptive and bivariate analyses. Results: Overall, respondents in caregiving households (n = 667) reported a significantly greater negative impact of social distancing on their family functioning, with greater increase in conflict than nonadult caregiving households (n = 3,574). Significantly more caregiving households also reported that someone had stopped working due to the pandemic. No differences were observed for cohesion between the two groups, with both reporting a little bit more cohesion when compared with the period before social distancing. Conclusions: Our findings add to a body of literature demonstrating that caregiving families experience greater disruption and strain during disaster situations such as the COVID-19 pandemic. Future research is needed to establish the causality of the collected proximal factors, such as job loss and education, with pandemic related family functioning among homes caring for adults, and examining the impact of contextual factors, such as level of caregiving need and caregiving support. (PsycInfo Database Record (c) 2021 APA, all rights reserved).