A Longitudinal Examination of Social Support Correlates Among HIV-Positive Younger Black Men Who Have Sex with Men (YBMSM)

Background: Nationwide, HIV rates among young Black men who have sex with men (YBMSM) ages 15 to 29 are three and five times higher than their Latino and White counterparts, respectively. Additionally, Black youth and young adults, ages 13-24, represent more than half (57%) of all new HIV infections in that age group. Recent research has highlighted that low social support satisfaction among HIV-infected youth is correlated with increased substance use, depression and lower adherence to HIV treatment and engagement in care. Consequently, interventions aimed at HIV-positive young MSM have utilized various social support methods to promote HIV adherence and treatment. However, despite evidence which documents that social support is a critical factor for promoting the quality of life for HIV infected youth and their adherence and engagement in medical care, there is a dearth of research examining the long-term predictors of social support, especially for YBMSM, which this study addresses.  

Methods: Data was collected, across three waves, between October 2012 and November 2014 as part of the baseline assessment from Project nGage, a preliminary efficacy randomized control, examining the role of social support in improving HIV-care among HIV-positive YBMSM. The sample included 92 YBMSM. Participants ranged in age from 18 to 29 with an average age of 23.9. Across all three waves measures were assessed for psychological distress (BSI), substance use, time of diagnosis, self-esteem, and social network size as potential predictors of the dependent variable social support satisfaction. In order to determine which covariates were predictive of social support satisfaction over a two year period, a repeated measures ANCOVA was computed.  

Results: Given the small sample size only covariates that were correlated with social support satisfaction at p <.10 were entered into the ANCOVA. This resulted in self-esteem, psychological health, social network size and time since diagnosis being entered into the models. Controlling for possible intervention effects, major results indicated that psychological health at wave three was predictive of differences in social support satisfaction, F(2, 88)=4.11, p<.05, η2=.085. More specifically, persons who reported more psychological health problems had lower social support satisfaction from family and friends. There was no evidence that self-esteem, social network size, and length of HIV diagnosis were associated with social support satisfaction among this sample of HIV-positive YBMSM.

Implications: Given that poorer psychological health was predictive of lower levels of social support satisfaction, it is critical that interventions focused on promoting the well-being and effective treatment of HIV-positive YBMSM focus on their mental health concerns. HIV-positive YBMSM have poorer engagement and retention in HIV care than their Latino and White counterparts which has major negative implications for the curtailment of HIV within their communities. These findings suggest that, within resource constrained agency settings, focusing on psychological heath is a critical HIV public heath priority, and that persons reporting mental  health concerns, irrespective of the size of their social networks, self-esteem and time since being diagnosed with HIV, should be targeted for early services.