Maria De Jesus1, Deanna Ware2, Andre L Brown3, James E Egan3, Sabina A Haberlen4, Frank Joseph Palella5, Roger Detels6, M Reuel Friedman7, Michael W Plankey2. 1. School of International Service, Center on Health, Risk, and Society, American University, Washington, DC, USA. Electronic address: dejesus@american.edu. 2. Georgetown University Department of Medicine, Washington, DC, USA. 3. Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA. 4. Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. 5. Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 6. Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA. 7. Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
Abstract
RATIONALE: Loneliness is associated with negative health outcomes, such as cardiovascular disease, cognitive impairment, dementia, physical functional decline, depression, and increased mortality risk, among HIV- positive and HIV-negative older men who have sex with men (MSM). Given these negative health outcomes, it is imperative to identify factors that minimize loneliness in these vulnerable groups. OBJECTIVE: We sought to examine whether social-environmental resiliencies-defined as an individual's level of support, social bonding, and psychological sense of community among gay men-buffer against symptoms of loneliness. METHOD: We analyzed longitudinal data from 1,255 older MSM with and without HIV infection, all of whom were enrolled in the Multicenter AIDS Cohort Study (MACS). Using longitudinal latent class analysis (LLCA), we identified three underlying classes (Social Connectors, Non-community Connectors, and Social Isolates) in the social environment of the sample. We assessed the prevalence of loneliness by these latent classes. By lagging social environmental factors over time, we were able to examine the temporal relationships between latent classes and subsequent loneliness. RESULTS: Consistent with our hypothesis, multivariate associations revealed that compared to Social Connectors with high levels of social support and social bonding and a strong perceived sense of community among gay men, Social Isolates (Prevalence Ratio (PR): 1.42; 95% CI: 1.08-1.88; p = 0.0120) and Non-community Connectors (PR: 1.34; 95% CI: 1.03-1.75; p = 0.0322) were more likely to experience loneliness after adjustment for covariates and baseline loneliness. There were no differences by HIV status. CONCLUSIONS: These longitudinal data allowed us to make causal inferences related to the social environmental resiliencies lowering the odds of loneliness among HIV-positive and HIV-negative older MSM. Developing individual- and community-level tailored interventions for these populations by leveraging social environmental resiliencies is key to reducing loneliness and promoting health.
RATIONALE: Loneliness is associated with negative health outcomes, such as cardiovascular disease, cognitive impairment, dementia, physical functional decline, depression, and increased mortality risk, among HIV- positive and HIV-negative older men who have sex with men (MSM). Given these negative health outcomes, it is imperative to identify factors that minimize loneliness in these vulnerable groups. OBJECTIVE: We sought to examine whether social-environmental resiliencies-defined as an individual's level of support, social bonding, and psychological sense of community among gay men-buffer against symptoms of loneliness. METHOD: We analyzed longitudinal data from 1,255 older MSM with and without HIV infection, all of whom were enrolled in the Multicenter AIDS Cohort Study (MACS). Using longitudinal latent class analysis (LLCA), we identified three underlying classes (Social Connectors, Non-community Connectors, and Social Isolates) in the social environment of the sample. We assessed the prevalence of loneliness by these latent classes. By lagging social environmental factors over time, we were able to examine the temporal relationships between latent classes and subsequent loneliness. RESULTS: Consistent with our hypothesis, multivariate associations revealed that compared to Social Connectors with high levels of social support and social bonding and a strong perceived sense of community among gay men, Social Isolates (Prevalence Ratio (PR): 1.42; 95% CI: 1.08-1.88; p = 0.0120) and Non-community Connectors (PR: 1.34; 95% CI: 1.03-1.75; p = 0.0322) were more likely to experience loneliness after adjustment for covariates and baseline loneliness. There were no differences by HIV status. CONCLUSIONS: These longitudinal data allowed us to make causal inferences related to the social environmental resiliencies lowering the odds of loneliness among HIV-positive and HIV-negative older MSM. Developing individual- and community-level tailored interventions for these populations by leveraging social environmental resiliencies is key to reducing loneliness and promoting health.
Authors: Juan M Leyva-Moral; Francesc Martínez-Batlle; Miguel Vázquez-Naveira; Juanse Hernández-Fernández; Marta Villar-Salgueiro Journal: J Assoc Nurses AIDS Care Date: 2019 Jan-Feb Impact factor: 1.354
Authors: Peter Mazonson; Jeff Berko; Theoren Loo; Mark Kane; Andrew Zolopa; Frank Spinelli; Maile Karris; Peter Shalit Journal: AIDS Care Date: 2020-02-12
Authors: M Reuel Friedman; Mirjam-Colette Kempf; Lorie Benning; Adaora A Adimora; Bradley Aouizerat; Mardge H Cohen; Queen Hatfield; Dan Merenstein; Matthew J Mimiaga; Michael W Plankey; Anjali Sharma; Anandi N Sheth; Catalina Ramirez; Valentina Stosor; Marc C E Wagner; Tracey E Wilson; Gypsyamber D'Souza; Deborah Jones Weiss Journal: J Acquir Immune Defic Syndr Date: 2021-12-15 Impact factor: 3.771