Physiological Changes from Violence-Induced Stress and Trauma Enhance HIV Susceptibility Among Women

  • Kiyomi TsuyukiEmail author
  • Andrea N. Cimino
  • Charvonne N. Holliday
  • Jacquelyn C. Campbell
  • Noor A. Al-Alusi
  • Jamila K. Stockman
Behavioral Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Behavioral-Bio-Medical Interface


Purpose of Review

This theoretical review identifies physiological mechanisms by which violence against women (VAW) may increase women’s susceptibility to HIV through trauma, stress, and immune dysfunction.

Recent Findings

Research documents systemic and local immune responses are related to stress and trauma from abuse across the life course (i.e., childhood, IPV, adulthood re-victimization). Findings are interpreted within a theoretical framework grounded in the Social Stress Theory and the concept of toxic stress, and highlight the current state of the science connecting: (1) VAW to the physiological stress response and immune dysfunction, and (2) the physiological stress response and inflammation to HIV susceptibility and infection in the female reproductive tract.


Despite a dearth of research in human subjects, evidence suggests that VAW plays a significant role in creating a physiological environment conducive to HIV infection. We conclude with a discussion of promising future steps for this line of research.


HIV Violence against women Trauma Physiological stress response Immune dysfunction 


Funding Information

This research was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD077891 - support for J.K. Stockman, J.C. Campbell, A.N. Cimino, C.N. Holliday, and K. Tsuyuki; R01HD077891-04S1 – support for K. Tsuyuki; T32HD064428 – J. Campbell, C.N. Holliday and A. N. Cimino), the National Institute of Alcoholism and Alcohol Abuse (K01AA025009 - K. Tsuyuki), the National Institute of Drug Abuse (K01DA031593 - J.K. Stockman; T32DA023356 - K. Tsuyuki), the National Institute on Minority Health and Health Disparities (L60MD003701 - J.K. Stockman; L60MD011184- K. Tsuyuki; 1L60MD012089-01 – C.N. Holliday), the Health Resources and Services Administration (T76MC00003 – C.N. Holliday), Johns Hopkins University Center for AIDS Research (P30AI094189), and the UCSD Center for AIDS Research (P30AI036214).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kiyomi Tsuyuki
    • 1
    Email author
  • Andrea N. Cimino
    • 2
  • Charvonne N. Holliday
    • 3
  • Jacquelyn C. Campbell
    • 2
  • Noor A. Al-Alusi
    • 1
  • Jamila K. Stockman
    • 1
  1. 1.Division of Infectious Diseases and Global Public Health, Department of MedicineUniversity of California, San DiegoLa JollaUSA
  2. 2.Department of Community-Public HealthJohns Hopkins University School of NursingBaltimoreUSA
  3. 3.Department of Population, Family and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA

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