The Association between IPV and Innate, Cellular, and Humoral Immune Responses: A Systematic Review of the Literature Público

Chandrakumar, Koushalya (Spring 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/sj1392991?locale=es
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Abstract

Background

Intimate partner violence (IPV) remains a serious public health problem both nationally and globally, given its high prevalence and association with poor mental and physical health. To date, most of the available research focuses on examination of the effect of IPV experience on risk of development of chronic, non-communicable diseases, sexually transmitted infections including HIV, and mental health disorders. Given the well-established link between IPV and various communicable diseases, there is a need to understand whether and how IPV may affect innate, cellular and humoral immunity. The goal of this review is to analyze the breadth of literature available on the topic, assess the gaps in knowledge among what has been studied (i.e. by population, by disease outcome, study design) and to explore trends across studies in association between IPV and innate, cellular and humoral immunity.

Methods

           A systematic review of peer-reviewed literature was conducted using three search engines to identify articles that examined the relationship between IPV and immune response in both individuals who have experienced IPV as well as perpetrated IPV. Article titles and abstract were first examined for relevancy and thereafter, if potentially relevant, the full text was reviewed to determine whether the study was eligible for inclusion. Next, data regarding study design, population, predictors, outcomes, and findings was extracted. Lastly, the quality of the included studies was assessed. All findings were descriptively synthesized and examined to ascertain the strengths and gaps in available studies and summarize findings to date.

Results

The search yielded 17 articles. The studies were mostly cross-sectional in design and focused on women who experienced IPV in the United States and Spain. Among the immune outcomes examined across articles, the most highly studied areas included cytokine response (specifically IL-6 and IL-10), CRP levels, T-cell numbers, differentiation, and functionality (especially in the context of HIV), and HSV-specific antibody responses. Several studies examined the association between IPV experience and IL-6, but with discrepant results. Only two studies examined the association between IPV perpetration and immune outcomes, both examining the link between aggression and sIgA levels among perpetrators.  

Conclusions

There exists a large gap in the literature examining the impact of IPV experience and perpetration on immune responses, which could be of critical importance given the causal link between IPV and infectious diseases and should be addressed by future research.

Table of Contents

Table of Contents

Introductory Pages

Distribution Agreement... I

Thesis Committee Approval Form... II

Abstract Title Page... III

Abstract... IV

Acknowledgments... V

Chapter 1: Introduction...8

Background and Significance...8

Statement of Purpose... 13

Chapter 2: Methods...13

Chapter 3: Results...16

Article Yield...16

Study Population...18

Study Design...19

Predictor Variable...19

Instrument Used...20

Outcome Measure...21

Method of Outcome Assessment...22

Findings...22

       T-Cell Function...22

       Il-6 and Il-10 Levels ...23

       Changes in IgA Levels...24

       CRP Levels...24

       Other measures of Immune Response...25

       IPV Perpetrators...26

Quality Assessment of Included Studies...26

Chapter 4: Discussion...36

Limitations...41

Public Health Implications...41

Tables and Figures

Table 1: Search Terms Used in Databases... 14

Table 2: Characteristics of Articles Included in Review...28

Table 3: Quality assessments of quantitative studies... 31

Table 4: Summary of Findings included in the review...43

Figure 1: PRISMA Diagram...17

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