Spotlight Research Presentations
LGBQT+
David W. Pantalone, Ph.D.
Professor of Psychology
University of Massachusetts Boston
Boston, Massachusetts
Annesa Flentje, Ph.D.
Associate Professor
University of California San Francisco
San Francisco, California
Minority stress is thought to have direct and indirect effects on the biology of sexual and gender minority people. Systematic review shows relationships between minority stress and overall physical health, infection, immune response, HIV-related outcomes, AIDS mortality, cardiovascular markers, BMI, cortisol, and cancer incidence and treatment side effects (Flentje et al., 2020). Unfortunately, most of these studies are correlational. Self-report measures of minority stress have limited psychometric evidence and are impacted by cognitive understanding of minority stress experiences and response styles. Experimental paradigms modeling minority stress are limited and only account for acute responses to minority stress. Gene expression can be useful in tracking response to interventions by elucidating the gene pathways and downstream processes impacted by the intervention (e.g., Buric, et al., 2017), and cognitive-behavioral interventions improves immune function (Shields et al., 2020). Further, gene expression is cross-sectionally related to minority stress (Flentje, et al., 2018). This suggests that examining gene expression as an outcome for a cognitive-behavioral intervention targeting minority stress may elucidate the biological mechanisms of minority stress and reversal of those mechanisms.
We developed and studied AWARENESS, a 9-session cognitive-behavioral intervention that provides skills to cope with stigma and discrimination related to intersectional identities and characteristics (Flentje, 2020). AWARENESS demonstrated acceptability and feasibility in a pilot randomized controlled trial of 42 sexual minority men living with HIV who use substances (Flentje et al., under review). We will present new results showing that AWARENESS is related to changes in gene expression in leukocyte RNA in 59 pathways, many of which are implicated in immune function, while the active control condition was related to changes in gene expression among genes in only 2 pathways. This work will highlight the possibility of using cognitive behavioral interventions and designs using gene expression as a novel mechanism to enable more rigorous inferences to investigate pervasive stress related to minority status.