Overview
This is a basic human experimental study utilizing 4 groups of individuals with and without HIV and complex morbidities of cannabis use disorder and major depression who will participate in 2 sessions of the Yale Pain Stress Task (YPST) and follow-up phase to assess drug use and mood symptoms.
Description
This study aims to address research gaps using a powerful and novel cross-diagnostic approach with multiple complementary approaches to examine the overarching hypothesis that PLWH+CM exhibit impaired stress-related HPA and HPA-immune function due to alterations in epigenetic mechanisms, and these stress-related HPA-immune and related epigenetic aberrations predict distress, craving and substance use symptoms underlying PLWH complex morbidities. This hypothesis will be tested using a combined human experimental stress challenge approach with prospective longitudinal assessment of daily distress, and substance use symptoms as well as assessment of chronic stress (C-stress), social determinants of health (SDoH), and resilience in experimental cohorts of PLWH with and without CM and those without HIV with and without CM.
Eligibility
Inclusion Criteria:
- good health as verified by screening examination
- Able to read English and complete study evaluations and provide informed written and verbal consent. Additional criteria PLWH
- HIV-1 lab test positive
- undetectable viral load
- good ART adherence
Additional criteria by group:
PLWH +CM:
- CB positive urine toxicology
- meet DSM-5 criteria for CUD and MDD as assessed using SCID-I. HC
- HIV-1 test negative
- urine toxicology negative
- no major medical and psychiatric diagnoses based on DSM-V.
PLWH Only:
- HIV-1 test positive
- urine toxicology negative
- no major medical and psychiatric diagnoses based on DSM-V.
CM Only:
- HIV-1 test negative
- urine toxicology positive
- meet DSM-5 criteria for CUD and MDD as assessed using SCID-I
Exclusion Criteria:
- meet primary, current moderate and severe criteria for other SUD including cocaine, alcohol, opiates, sedatives, nicotine
- current use or past history of cocaine or opioid use disorder
- history of any psychotic disorder
- current diagnoses of bipolar disorder and PTSD
- psychotic or otherwise severely psychiatrically disabled (i.e., suicidal, homicidal, current mania)
- significant underlying medical conditions such as cerebral, renal, thyroid or cardiac pathology that would interfere with study participation
- medications with known central effects on HPA axis and cytokines/immune function
- women who are pregnant, nursing or those using hormonal birth control that affect HPA axis cortisol responses.