Women’s mental health and HIV
By Dianne Langford
The program of research directed by Dr. Leah Rubin elucidates neuroendocrine mechanisms contributing to mental and cognitive health in women. She focuses on the effect of sex steroid hormones, glucocorticoids, vasopressin, and oxytocin on cognition and mental health in healthy women, female psychiatric patients, and women living with HIV. A central long-term goal is to improve the cognitive health of HIV-infected women through an interdisciplinary research career that incorporates epidemiological, mechanistic, and intervention science. “Conducting women’s mental health research requires a collaborative and translational approach, and a perspective that is typically larger than the skills of any one individual or any single, traditional discipline,” Dr. Rubin said.
Dr. Rubin is an assistant professor in the University of Illinois at Chicago (UIC) Department of Psychiatry and Women’s Mental Health Research Program. She is also an active member of the Neurocognitive Working Group (NCWG) of the Women’s Interagency HIV Study (WIHS), the nation’s largest prospective study of the natural and treated history of HIV in women. In her NIMH-funded HIV work, she focuses specifically on the detrimental effects of stress (perceived stress, post-traumatic stress), psychiatric comorbidities, and stress hormones on cognition and brain function in HIV-infected women at both the epidemiological and mechanistic levels (e.g., pharmacological challenge studies). As part of her work she has developed and applied sophisticated statistical approaches to assess the influence of HIV on cognitive functioning.
Collaborative publications resulting from investigations conducted in the WIHS have helped to elucidate the association between HIV status and cognition in women as well as identify risk factors for cognitive difficulties (N~1500). This work has demonstrated that HIV-infected women show a prominent deficit in verbal learning and memory and attention (Maki et al., Neurology 2015). Through multiple studies, Dr. Rubin has helped to identify certain factors that are differentially associated with verbal learning and memory in HIV-infected compared to HIV-uninfected women, including perceived stress, anxiety, crack/cocaine use, menopausal anxiety, and insulin resistance (Rubin et al., J Neurovirol 2015; Rubin et al., Menopause 2014; Meyer et al., J Acquir Immune Defic Syndr 2013; Valcour et al., J Neurovirol 2015; Meyer et al. J Neurovirol 2014). Her collaborative neuroimaging projects suggest that the prefrontal cortex plays a critical role in stress- and drug-related memory impairments in HIV-infected women. Dr. Rubin’s body of research is aimed at improving scientific knowledge and guiding treatment development for cognition in HIV-infected women.