Increasing Social Support for Young Adults With HIV Could Improve Viral Suppression

Improving social support for young adults with perinatally-acquired HIV can help to increase viral suppression among this population as they prepare for transition to adult clinical care, according to the results of a study published by Clinical Epidemiology.

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Investigators included 444 individuals aged 18 years and older and were enrolled in Adolescent Master Protocol Up, a study of a pediatric HIV/AIDS cohort. Individuals were included from 14 clinical research sites with long-term follow-up in the United States, including Puerto Rico.

Individuals had social support evaluations and an HIV viral load of 1 or greater over the next year. Using the National Institutes of Health Toolbox, investigators evaluated the emotional, instrumental, and friendship social support of individuals in the study.

Social support was defined as low with a T-score of 40 or less, average at 41 to 59, and high at 60 or greater, which were measured at study entry and at year 3, if available. Viral suppression was defined as all viral loads less than 50 copies/mL over 1 year after the social support measures. Investigators used a multivariable Poisson regression model to generate estimations and evaluated the transition from pediatric to adult care.

Low emotional, instrumental, and friendship support at entry was reported by 37%, 32%, and 36%, respectively. For average and high, emotional support was reported for 47% and 17%, instrumental support for 57% and 10%, and friendship support for 50% and 14%, respectively.

Additionally, the study showed that mean instrumental social support and friendship was higher for those aged 18 to 20 years than for older individuals, with a mean friendship higher in males than females. Further, those who were Black were more likely to report low levels of emotional and instrumental support than those who were White or other races. Those who were Hispanic were less likely to report low emotional support than those who were non-Hispanic.

Within the next year, approximately 44% had viral suppression and 45% were at the 3-year period. Investigators found that average or high levels of all 3 support measures were associated with a likelihood of viral suppression. Additionally, there were no differences between those who had high or average social support in the proportion of viral suppression.

Instrumental support was also associated with viral suppression among pediatrics, but not in adult care. In pediatric care, 51.2% of those with average or high instrumental support had viral suppression compared to 28.9% with low support. In adult care, both average and high support were comparable to those with low support at 40% and 40.8%, respectively.

The study had data limitations, as investigators were not sure whether individuals were reporting support from family, friends, or physicians, which could be useful to further enhance social networks among these individuals. Additionally, the results were limited due to some individuals not being retained through their care, which could have impacted data on both lower social support and lower likelihood of viral suppression.

Reference

Tassiopoulos K, Huo Y, Kacanek D, Malee K, et al. 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). Clin Epidemiol. 2023;15:601-611. doi:10.2147/CLEP.S403570