Moderating effects of social support on the relationship between substance use disorders and HIV viral load and medication adherence among Black women living with HIV in the United States

ABSTRACT

Substance use may predict lower rates of antiretroviral therapy (ART) adherence and viral suppression among Black Women Living with HIV (BWLWH). We assessed how perceived social support (PSS) moderates the relationship between substance use disorder (SUD) and viral load (VL) and ART adherence. 119 BWLWH provided information on PSS, SUD, alcohol use disorder (AUD) and adherence (via Wisepill). Higher PSS from friends (β = −.263, p = .008) and significant others (β = −.219, p = .025) predicted lower VL. SUD predicted low Wisepill adherence (a) in the past week (β = −.273, p = .035) and past two weeks (β = −.273, p = .033) only for women low in PSS from friends, and (b) in the past two weeks only for women low in total PSS (β = −.294, p = .024). Ironically, for women high in total PSS, SUD predicted higher adherence in the past four weeks (β = .360, p = .006). Adherence and VL may be bolstered by understanding the role of various forms of PSS and SUDs.

KEYWORDS:

• Black women
• HIV
• substance use
• social support
• viral load

Acknowledgements

We would like to extend extensive gratitude to the women who participated in this study, research staff and volunteers, and community stakeholders. The research reported in this publication was funded by K23MH108439 and the principal investigator Dr. Sannisha Dale was additionally funded by R56MH121194 and R01MH121194 from the National Institute of Mental Health. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure statement

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

Compliance with ethical standards

Conflict of Interest: The authors declare that they have no conflict of interest.

Informed Consent: Informed consent was obtained for all enrolled participants.

Research involving human subjects: The study protocol was approved by the University of Miami Institutional Review Board.

Additional information

Funding

The research reported in this publication was funded by K23MH108439 and the principal investigator Dr. Sannisha Dale was additionally funded by R56MH121194 and R01MH121194 from the National Institute of Mental Health.