Clinical Epidemiology (May 2023)

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)

  • Tassiopoulos K,
  • Huo Y,
  • Kacanek D,
  • Malee K,
  • Nichols S,
  • Mellins CA,
  • Kohlhoff S,
  • Van Dyke RB

Journal volume & issue
Vol. Volume 15
pp. 601 – 611

Abstract

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Katherine Tassiopoulos,1 Yanling Huo,2 Deborah Kacanek,2 Kathleen Malee,3 Sharon Nichols,4 Claude A Mellins,5 Stephan Kohlhoff,6 Russell B Van Dyke7 On behalf of the Pediatric HIV/AIDS Cohort Study1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; 2Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA, USA; 3Departments of Infectious Diseases and Psychiatry and Behavioral Science, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; 4Department of Neurosciences, University of California San Diego, La Jolla, CA, USA; 5Psychiatry and Sociomedical Sciences, Columbia University, New York, NY, USA; 6Division of Pediatric Infectious Diseases, SUNY Downstate Medical Center, Brooklyn, NY, USA; 7Pediatric Infectious Diseases, Tulane University School of Medicine, New Orleans, LA, USACorrespondence: Katherine Tassiopoulos, Senior Research Scientist, Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Kresge 817B, Boston, MA, 02115, USA, Tel +1 617 432 3265, Fax +1 617 566 7805, Email [email protected]: 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: social support, perinatal HIV, young adults, viral suppression, clinical care transition

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