Impact and correlates of sub-optimal social support among patients in HIV care

ABSTRACT

Social support (SS) predicts health outcomes among patients living with HIV. We administered a brief, validated measure of SS, the Multifactoral Assessment of Perceived Social Support, within a patient-reported outcomes assessment of health domains in HIV care at 4 U.S. clinics in English and Spanish (n = 708). In univariate analysis, low SS was associated with poorer engagement in care, antiretroviral adherence, and health-related quality of life; current methamphetamine/crystal use, depression, anxiety, and HIV stigma (all p < 0.001); any use of either methamphetamines/crystal, illicit opioids, or cocaine/crack (p = 0.001), current marijuana use (p = 0.012), nicotine use (p = 0.005), and concern for sexually transmitted infection exposure (p = 0.001). High SS was associated with undetectable viral load (p = 0.031). Multivariate analyses found low SS independently associated with depression (risk ratio (RR) 3.72, 95% CI 2.93–4.72), lower adherence (RR 0.76, 95% CI 0.64–0.89), poor engagement in care (RR 2.05, 95% CI 1.44–2.96), and having more symptoms (RR 2.29, 95% CI 1.92–2.75). Medium SS was independently associated with depression (RR 2.59, 95% CI 2.00–3.36), poor engagement in care (RR 1.62, 95% CI 1.15–2.29) and having more symptoms (RR 1.75, 95% CI 1.44–2.13). SS assessment may help identify patients at risk for these outcomes.

KEYWORDS:

• Social support
• patient reported outcomes
• HIV care

Acknowledgements

We thank our patients, as well as the Madison Clinic Patient Panel for guidance in domain selection and development of the measure. This work was funded by the Patient Centered Outcomes Research Institute (PCORI) SC14-1403-14081 with additional support from the National Institute of Allergy and Infectious Diseases (NIAID) [CNICS R24 AI067039, UW CFAR NIAID Grant P30 AI027757; and UAB CFAR grant P30 AI027767].

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was funded by the Patient Centered Outcomes Research Institute (PCORI) SC14-1403-14081 with additional support from the National Institute of Allergy and Infectious Diseases (NIAID) [CNICS R24 AI067039, UW CFAR NIAID Grant P30 AI027757; and UAB CFAR grant P30 AI027767].