Intensity of Social Support Matters: A Latent Class Analysis to Identify Levels of Social Support Associated with Optimal Health Outcomes Among Women Living with HIV

Aruna Chandran; Fiona Bhondoekhan; Tracey E Wilson; Joel Milam; Mardge H Cohen; Adaora A Adimora; Adebola Adedimeji; Jennifer Cocohoba; Carrigan Parish; Marcia Holstad; Seble Kassaye; Mirjam-Colette Kempf

doi:10.1007/s10461-021-03377-8

Intensity of Social Support Matters: A Latent Class Analysis to Identify Levels of Social Support Associated with Optimal Health Outcomes Among Women Living with HIV

AIDS Behav. 2022 Jan;26(1):243-251. doi: 10.1007/s10461-021-03377-8. Epub 2021 Jul 21.

Authors

Affiliations

¹ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Suite W6501, Baltimore, MD, 21205, USA. achandr3@jhu.edu.
² Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Suite W6501, Baltimore, MD, 21205, USA.
³ Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
⁴ Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
⁵ Cook County Health and Hospital System, Chicago, IL, USA.
⁶ Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁷ Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
⁸ Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, USA.
⁹ Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
¹⁰ Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA.
¹¹ Department of Medicine/Infectious Diseases, Georgetown University, Washington, DC, USA.
¹² Schools of Nursing, Public Health and Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

Abstract
in English, Spanish

Social support is associated with improved HIV care and quality of life. We utilized latent class analysis to identify three classes of baseline emotional and tangible perceived social support, termed "Strong", "Wavering" and "Weak". "Weak" vs. "Strong" perceived social support was associated over time with an 8% decreased risk of optimal antiretroviral therapy (ART) adherence for emotional and 6% decreased risk for tangible perceived social support. Importantly, "Wavering" vs "Strong" social support also showed a decreased risk of ART adherence of 6% for emotional and 3% for tangible support. "Strong" vs. "Weak" perceived support had a similar association with undetectable viral load, but the association for "Strong" vs. "Wavering" support was not statistically significant. Intensity of social support is associated with HIV care outcomes, and strong social support may be needed for some individuals. It is important to quantify the level or intensity of social support that is needed to optimize HIV outcomes.

El apoyo social está asociado con una mejor atención y calidad de vida del virus de inmunodeficiencia humana (VIH). Utilizamos el análisis de clase latente para identificar tres clases de apoyo social percibido emocional y tangible de referencia, denominado "fuerte", "vacilante" y "débil". El apoyo social percibido “débil” versus el “fuerte” se asoció con el tiempo con una disminución del 8% en el riesgo de una adherencia óptima al terapia antirretroviral (TAR) para el apoyo emocional y del 6% en el riesgo de un apoyo social percibido tangible. Es importante destacar que el apoyo social "vacilante" frente a "fuerte" también mostró una disminución del riesgo de adherencia al TAR del 6% para el apoyo emocional y del 3% para el apoyo tangible. El apoyo percibido "fuerte" frente a "débil" tuvo una asociación similar con una carga viral indetectable, pero la asociación entre el apoyo "fuerte" y el apoyo "vacilante" no fue estadísticamente significativa. La intensidad del apoyo social está asociada con los resultados de la atención del VIH, y algunas personas pueden necesitar un fuerte apoyo social. Es importante cuantificar el nivel o la intensidad del apoyo social que se necesita para optimizar los resultados del VIH.

Keywords: Adherence; HIV; Latent Class Analysis; Social Support; Viral Load; WIHS.

MeSH terms

Female
HIV Infections* / drug therapy
Humans
Latent Class Analysis
Medication Adherence
Outcome Assessment, Health Care
Quality of Life*
Social Support
Viral Load

Abstract in English, Spanish

MeSH terms

Grants and funding

Abstract
in English, Spanish