Association of Perceived Social Support with Viral Suppression Among Young Adults with Perinatally-Acquired HIV in the US-based Pediatric HIV/AIDS Cohort Study (PHACS)

Katherine Tassiopoulos, Yanling Huo, Deborah Kacanek, Kathleen Malee, Sharon Nichols, Claude A Mellins, Stephan Kohlhoff, Russell B Van Dyke, Pediatric HIV/AIDS Cohort Study, Katherine Tassiopoulos, Yanling Huo, Deborah Kacanek, Kathleen Malee, Sharon Nichols, Claude A Mellins, Stephan Kohlhoff, Russell B Van Dyke, Pediatric HIV/AIDS Cohort Study

Abstract

Purpose: To determine the relationship between perceived social support and viral suppression among young adults with perinatally-acquired HIV (YAPHIV).

Participants and methods: We included YAPHIV ≥18 years enrolled in AMP Up, a study of PHACS (Pediatric HIV/AIDS Cohort Study), with social support evaluations and ≥1 HIV viral load (VL) measured over the next year. We evaluated emotional, instrumental, and friendship social support via the NIH Toolbox. We defined social support, measured at study entry and year 3 (if available), as low (T-score ≤40), average (41-59) or high (≥60). We defined viral suppression as all VL <50 copies/mL over the one year after social support measures. We fit multivariable Poisson regression models using generalized estimating equations, and evaluated transition from pediatric to adult care as an effect modifier.

Results: Among 444 YAPHIV, low emotional and instrumental support and friendship at entry were reported by 37%, 32% and 36%. Over the next year, 44% were virally suppressed. Of 136 with year 3 data, 45% were suppressed. Average or high levels of all three social support measures were associated with higher likelihood of viral suppression. Instrumental support was associated with viral suppression among those in pediatric (adjusted proportion suppressed among those with average/high vs low support=51.2% vs 28.9%; risk ratio (RR)=1.77, 95% confidence interval (CI)=1.37, 2.29), but not adult care (40.0% vs 40.8%; RR=0.98, 95% CI=0.67, 1.44).

Conclusion: Sufficient social support increases likelihood of viral suppression among YAPHIV. Strategies to enhance social support may promote viral suppression as YAPHIV prepare for adult clinical care transition.

Keywords: clinical care transition; perinatal HIV; social support; viral suppression; young adults.

Conflict of interest statement

Dr Katherine Tassiopoulos, Ms Yanling Huo, Dr Deborah Kacanek, Dr Sharon Nichols and Dr Russell B Van Dyke report grants from the National Institutes of Health, during the conduct of the study; grants from the National Institutes of Health, outside the submitted work. Dr Kathleen Malee reports grants from the National Institutes of Health, during the conduct of the study. Dr Stephan Kohlhoff reports grants from the National Institutes of Health, during the conduct of the study; grants from Pfizer, grants from DiaSorin, outside the submitted work. The authors report no other conflicts of interest in this work.

© 2023 Tassiopoulos et al.

Figures

Figure 1
Figure 1
Effect modification by care transition status on social support. Y-axis represents adjusted proportion of viral suppression for each combination of social support and transition status strata. RR: Adjusted risk ratio of viral suppression comparing participants within each combined stratum of social support and transition status to the reference stratum (=low support + adult care). RERI (additive interaction) = (combined effect of transition status and social support) - (individual effect of transition status) - (individual effect of social support) + 1. Ratio of RR (multiplicative interaction) = (combined effect of transition status and social support) / (individual effect of transition status) * (individual effect of social support). Viral load measures assessed in the one-year period (3–15 months) following social support assessments at entry and year 3. Viral suppression was defined as all viral load measures over one-year period

References

    1. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010;7(7):e1000316. doi:10.1371/journal.pmed.1000316
    1. Rad GS, Bakht LA, Feizi A, Mohebi S. Importance of social support in diabetes care. J Educ Health Promot. 2013;2:62. doi:10.4103/2277-9531.120864
    1. DiMatteo MR. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychol. 2004;23(2):207–218. doi:10.1037/0278-6133.23.2.207
    1. Gariépy G, Honkaniemi H, Quesnel-Vallée A. Social support and protection from depression: systematic review of current findings in Western countries. Br J Psychiatry. 2016;209(4):284–293. doi:10.1192/bjp.bp.115.169094
    1. Kim SH, McDonald S, Kim S, Foster C, Fidler S. Importance of self-motivation and social support in medication adherence in HIV-infected adolescents in the United Kingdom and Ireland: a multicentre HYPNet Study. AIDS Patient Care STDS. 2015;29(6):354–364. doi:10.1089/apc.2014.0335
    1. Power R, Koopman C, Volk J, et al. Social support, substance use, and denial in relationship to antiretroviral treatment adherence among HIV-infected persons. AIDS Patient Care STDS. 2003;17(5):245–252. doi:10.1089/108729103321655890
    1. Haberer JE, Bwana BM, Orrell C, et al. ART adherence and viral suppression are high among most non-pregnant individuals with early-stage, asymptomatic HIV infection: an observational study from Uganda and South Africa. J Int AIDS Soc. 2019;22(2):e25232. doi:10.1002/jia2.25232
    1. Williams PL, Storm D, Montepiedra G, et al. Predictors of adherence to antiretroviral medications in children and adolescents with HIV infection. Pediatrics. 2006;118(6):e1745–1757. doi:10.1542/peds.2006-0493
    1. Kacanek D, Huo Y, Malee K, et al. Nonadherence and unsuppressed viral load across adolescence among US youth with perinatally acquired HIV. AIDS. 2019;33(12):1923–1934. doi:10.1097/QAD.0000000000002301
    1. Damulira C, Mukasa MN, Byansi W, et al. Examining the relationship of social support and family cohesion on ART adherence among HIV-positive adolescents in southern Uganda: baseline findings. Vulnerable Child Youth Stud. 2019;14(2):181–190. doi:10.1080/17450128.2019.1576960
    1. Amberbir A, Woldemichael K, Getachew S, Girma B, Deribe K. Predictors of adherence to antiretroviral therapy among HIV-infected persons: a prospective study in Southwest Ethiopia. BMC Public Health. 2008;8:265. doi:10.1186/1471-2458-8-265
    1. Kalichman SC, DiMarco M, Austin J, Luke W, DiFonzo K. Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women. J Behav Med. 2003;26(4):315–332. doi:10.1023/A:1024252926930
    1. Lee S, Yamazaki M, Harris DR, Harper GW, Ellen J. Social support and human immunodeficiency virus-status disclosure to friends and family: implications for human immunodeficiency virus-positive youth. J Adolesc Health. 2015;57(1):73–80. doi:10.1016/j.jadohealth.2015.03.002
    1. McDowell TL, Serovich JM. The effect of perceived and actual social support on the mental health of HIV-positive persons. AIDS Care. 2007;19(10):1223–1229. doi:10.1080/09540120701402830
    1. Matsumoto S, Yamaoka K, Takahashi K, et al. Social support as a key protective factor against depression in HIV-infected patients: report from large HIV clinics in Hanoi, Vietnam. Sci Rep. 2017;7(1):15489. doi:10.1038/s41598-017-15768-w
    1. Galvan FH, Davis EM, Banks D, Bing EG. HIV stigma and social support among African Americans. AIDS Patient Care STDS. 2008;22(5):423–436. doi:10.1089/apc.2007.0169
    1. Simoni JM, Frick PA, Huang B. A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy. Health Psychol. 2006;25(1):74–81. doi:10.1037/0278-6133.25.1.74
    1. Burgoyne RW. Exploring direction of causation between social support and clinical outcome for HIV-positive adults in the context of highly active antiretroviral therapy. AIDS Care. 2005;17(1):111–124. doi:10.1080/09540120412331305179
    1. Knowlton A, Arnsten J, Eldred L, et al. Individual, interpersonal, and structural correlates of effective HAART use among urban active injection drug users. J Acquir Immune Defic Syndr. 2006;41(4):486–492. doi:10.1097/01.qai.0000186392.26334.e3
    1. Knowlton AR, Arnsten JH, Gourevitch MN, et al. Microsocial environmental influences on highly active antiretroviral therapy outcomes among active injection drug users: the role of informal caregiving and household factors. J Acquir Immune Defic Syndr. 2007;46(Suppl 2):S110–119. doi:10.1097/QAI.0b013e31815767f8
    1. Friedman MR, Coulter RW, Silvestre AJ, et al. Someone to count on: social support as an effect modifier of viral load suppression in a prospective cohort study. AIDS Care. 2017;29(4):469–480. doi:10.1080/09540121.2016.1211614
    1. Kennedy MC, Kerr TH, Wood E, Shoveller JA, Montaner JSG, Milloy MS. Social and structural factors associated with greater time with a plasma HIV-1 RNA viral load above log10(1500) copies/mL among illicit drug users. AIDS. 2018;32(8):1059–1067. doi:10.1097/QAD.0000000000001777
    1. Scheurer D, Choudhry N, Swanton KA, Matlin O, Shrank W. Association between different types of social support and medication adherence. Am J Manag Care. 2012;18(12):e461–467.
    1. Norberg M, Stenlund H, Lindahl B, Andersson C, Eriksson JW, Weinehall L. Work stress and low emotional support is associated with increased risk of future type 2 diabetes in women. Diabetes Res Clin Pract. 2007;76(3):368–377. doi:10.1016/j.diabres.2006.09.002
    1. Hill M, Huff A, Chumbler N. Variation in networks and forms of support for care-seeking across the HIV care continuum in the rural Southeastern United States. J Rural Health. 2018;34(1):71–79. doi:10.1111/jrh.12238
    1. Kafetsios K, Sideridis GD. Attachment, social support and well-being in young and older adults. J Health Psychol. 2006;11(6):863–875. doi:10.1177/1359105306069084
    1. Maturo D, Powell A, Major-Wilson H, Sanchez K, De Santis JP, Friedman LB. Development of a protocol for transitioning adolescents with HIV infection to adult care. J Pediatr Health Care. 2011;25(1):16–23. doi:10.1016/j.pedhc.2009.12.005
    1. Abrams EJ, Mellins CA, Bucek A, et al. Behavioral health and adult milestones in young adults with perinatal HIV infection or exposure. Pediatrics. 2018;142:3. doi:10.1542/peds.2018-0938
    1. Kacanek D, Angelidou K, Williams PL, Chernoff M, Gadow KD, Nachman S. Psychiatric symptoms and antiretroviral nonadherence in US youth with perinatal HIV: a longitudinal study. AIDS. 2015;29(10):1227–1237. doi:10.1097/QAD.0000000000000697
    1. Yusuf H, Agwu A. Adolescents and young adults with early acquired HIV infection in the United States: unique challenges in treatment and secondary prevention. Expert Rev Anti Infect Ther. 2021;19(4):457–471. doi:10.1080/14787210.2021.1829473
    1. Patel K, Seage GR, Burchett SK, Hazra R, Van Dyke RB. Disparities in HIV viral suppression among adolescents and young adults by perinatal infection. Am J Public Health. 2019;109(7):e9. doi:10.2105/AJPH.2019.305108
    1. Weijsenfeld AM, Smit C, Wit F, et al. Long-term virological treatment outcomes in adolescents and young adults with perinatally and non-perinatally acquired human immunodeficiency virus. Open Forum Infect Dis. 2022;9(11):ofac561. doi:10.1093/ofid/ofac561
    1. Fair CD, Sullivan K, Dizney R, Stackpole A. ”It’s like losing a part of my family”: transition expectations of adolescents living with perinatally acquired HIV and their guardians. AIDS Patient Care STDS. 2012;26(7):423–429. doi:10.1089/apc.2012.0041
    1. Sharma N, Willen E, Garcia A, Sharma TS. Attitudes toward transitioning in youth with perinatally acquired HIV and their family caregivers. J Assoc Nurses AIDS Care. 2014;25(2):168–175. doi:10.1016/j.jana.2013.01.007
    1. Leserman J. HIV disease progression: depression, stress, and possible mechanisms. Biol Psychiatry. 2003;54(3):295–306. doi:10.1016/S0006-3223(03)00323-8
    1. Tassiopoulos K, Patel K, Alperen J, et al. Following young people with perinatal HIV infection from adolescence into adulthood: the protocol for PHACS AMP Up, a prospective cohort study. BMJ Open. 2016;6(6):e011396. doi:10.1136/bmjopen-2016-011396
    1. Gershon RC, Cella D, Fox NA, Havlik RJ, Hendrie HC, Wagster MV. Assessment of neurological and behavioural function: the NIH Toolbox. Lancet Neurol. 2010;9(2):138–139. doi:10.1016/S1474-4422(09)70335-7
    1. Cyranowski JM, Zill N, Bode R, et al. Assessing social support, companionship, and distress: national Institute of Health (NIH) toolbox adult social relationship scales. Health Psychol. 2013;32(3):293–301. doi:10.1037/a0028586
    1. Salsman JM, Butt Z, Pilkonis PA, et al. Emotion assessment using the NIH Toolbox. Neurology. 2013;80(11 Suppl 3):S76–86. doi:10.1212/WNL.0b013e3182872e11
    1. Babakhanyan I, McKenna BS, Casaletto KB, Nowinski CJ, Heaton RK. National institutes of health toolbox emotion battery for English- and Spanish-speaking adults: normative data and factor-based summary scores. Patient Relat Outcome Meas. 2018;9:115–127. doi:10.2147/PROM.S151658
    1. National Institutes of Health and Northwestern University. Toolbox scoring and interpretation guide for the iPad; 2021. Available from: . Accessed March 12, 2023.
    1. Knol MJ, VanderWeele TJ. Recommendations for presenting analyses of effect modification and interaction. Int J Epidemiol. 2012;41(2):514–520. doi:10.1093/ije/dyr218
    1. Mutevedzi PC, Lessells RJ, Rodger AJ, Newell ML. Association of age with mortality and virological and immunological response to antiretroviral therapy in rural South African adults. PLoS One. 2011;6(7):e21795. doi:10.1371/journal.pone.0021795
    1. Ryscavage P, Anderson EJ, Sutton SH, Reddy S, Taiwo B. Clinical outcomes of adolescents and young adults in adult HIV care. J Acquir Immune Defic Syndr. 2011;58(2):193–197. doi:10.1097/QAI.0B013E31822D7564
    1. Lotstein DS, Inkelas M, Hays RD, Halfon N, Brook R. Access to care for youth with special health care needs in the transition to adulthood. J Adolesc Health. 2008;43(1):23–29. doi:10.1016/j.jadohealth.2007.12.013
    1. Callahan ST, Cooper WO. Continuity of health insurance coverage among young adults with disabilities. Pediatrics. 2007;119(6):1175–1180. doi:10.1542/peds.2006-1881
    1. Arnett JJ, Žukauskienė R, Sugimura K. The new life stage of emerging adulthood at ages 18–29 years: implications for mental health. Lancet Psychiatry. 2014;1(7):569–576. doi:10.1016/S2215-0366(14)00080-7
    1. Scardera S, Perret LC, Ouellet-Morin I, et al. Association of social support during adolescence with depression, anxiety, and suicidal ideation in young adults. JAMA Network Open. 2020;3(12):e2027491. doi:10.1001/jamanetworkopen.2020.27491
    1. White PH, Cooley WC, Boudreau ADA. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2018;142(5). doi:10.1542/peds.2018-2587
    1. Wiener LS, Kohrt BA, Battles HB, Pao M. The HIV experience: youth identified barriers for transitioning from pediatric to adult care. J Pediatr Psychol. 2011;36(2):141–154. doi:10.1093/jpepsy/jsp129
    1. Lee S, Hazra R. Achieving 90-90-90 in paediatric HIV: adolescence as the touchstone for transition success. J Int AIDS Soc. 2015;18(Suppl 6):20257. doi:10.7448/IAS.18.7.20257
    1. Agwu AL, Lee L, Fleishman JA, et al. Aging and loss to follow-up among youth living with human immunodeficiency virus in the HIV Research Network. J Adolesc Health. 2015;56(3):345–351. doi:10.1016/j.jadohealth.2014.11.009
    1. Jacobson DE. Types and timing of social support. J Health Soc Behav. 1986;27(3):250–264. doi:10.2307/2136745
    1. Helgeson V. Two important distinctions in social support: kind of support and perceived versus received. J Appl Psychol. 1993;23(10):825–845.
    1. Chandran A, Bhondoekhan F, Wilson TE, et al. 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. 2021;26:243–251. doi:10.1007/s10461-021-03377-8
    1. Okonji EF, Mukumbang FC, Orth Z, Vickerman-Delport SA, Van Wyk B. Psychosocial support interventions for improved adherence and retention in ART care for young people living with HIV (10-24 years): a scoping review. BMC Public Health. 2020;20(1):1841. doi:10.1186/s12889-020-09717-y
    1. Reblin M, Uchino BN. Social and emotional support and its implication for health. Current Opin Psychiatry. 2008;21(2):201–205. doi:10.1097/YCO.0b013e3282f3ad89
    1. Long E, Patterson S, Maxwell K, et al. COVID-19 pandemic and its impact on social relationships and health. J Epidemiol Community Health. 2022;76(2):128–132. doi:10.1136/jech-2021-216690
    1. Blumenthal D, Fowler EJ, Abrams M, Collins SR. COVID-19 - implications for the health care system. N Engl J Med. 2020;383(15):1483–1488. doi:10.1056/NEJMsb2021088

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다