Social-environmental resiliencies protect against loneliness among HIV-Positive and HIV- negative older men who have sex with men: Results from the Multicenter AIDS Cohort Study (MACS)

Maria De Jesus; Deanna Ware; Andre L. Brown; James E. Egan; Sabina A. Haberlen; Frank Joseph Palella; Roger Detels; M. Reuel Friedman; Michael W. Plankey

doi:10.1016/j.socscimed.2021.113711

Social-environmental resiliencies protect against loneliness among HIV-Positive and HIV- negative older men who have sex with men: Results from the Multicenter AIDS Cohort Study (MACS)

Maria De Jesus^*, Deanna Ware, Andre L. Brown, James E. Egan, Sabina A. Haberlen, Frank Joseph Palella, Roger Detels, M. Reuel Friedman, Michael W. Plankey

^*Corresponding author for this work

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Article › peer-review

15 Scopus citations

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.

Original language	English (US)
Article number	113711
Journal	Social Science and Medicine
Volume	272
DOIs	https://doi.org/10.1016/j.socscimed.2021.113711
State	Published - Mar 2021

Funding

This study is funded by the National Institute for Minority Health Disparities [grant R01 MD010680 Plankey & Friedman]. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). MWCCS (Principal Investigators): Atlanta CRS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-HL146241; Baltimore CRS (Todd Brown and Joseph Margolick), U01-HL146201; Bronx CRS (Kathryn Anastos and Anjali Sharma), U01-HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202; Data Analysis and Coordination Center (Gypsyamber D'Souza, Stephen Gange and Elizabeth Golub), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245; Chicago-Northwestern CRS (Steven Wolinsky), U01-HL146240; Connie Wofsy Women's HIV Study, Northern California CRS (Bradley Aouizerat, Phyllis Tien, and Jennifer Price), U01-HL146242; Los Angeles CRS (Roger Detels), U01-HL146333; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146205; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-HL146203; Pittsburgh CRS (Jeremy Martinson and Charles Rinaldo), U01-HL146208; UAB-MS CRS (Mirjam-Colette Kempf, Jodie Dionne-Odom, and Deborah Konkle-Parker), U01-HL146192; UNC CRS (Adaora Adimora), U01-HL146194. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Institute On Aging (NIA), National Institute Of Dental & Craniofacial Research (NIDCR), National Institute Of Allergy And Infectious Diseases (NIAID), National Institute Of Neurological Disorders And Stroke (NINDS), National Institute Of Mental Health (NIMH), National Institute On Drug Abuse (NIDA), National Institute Of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute on Minority Health and Health Disparities (NIMHD), and in coordination and alignment with the research priorities of the National Institutes of Health, Office of AIDS Research (OAR). MWCCS data collection is also supported by UL1-TR000004 (UCSF CTSA), P30-AI-050409 (Atlanta CFAR), P30-AI-050410 (UNC CFAR), and P30-AI-027767 (UAB CFAR). The authors are indebted to the participants of the Multicenter AIDS Cohort Study [MACS] Healthy Aging Study. The authors thank the staff at the four sites for implementation support John Welty, Montserrat Tarrago, and Katherine McGowan for data support of this study. This study is funded by the National Institute for Minority Health Disparities [grant R01 MD010680 Plankey & Friedman]. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH) . MWCCS (Principal Investigators): Atlanta CRS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-HL146241; Baltimore CRS (Todd Brown and Joseph Margolick), U01-HL146201; Bronx CRS (Kathryn Anastos and Anjali Sharma), U01-HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202; Data Analysis and Coordination Center (Gypsyamber D’Souza, Stephen Gange and Elizabeth Golub), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245; Chicago-Northwestern CRS (Steven Wolinsky), U01-HL146240; Connie Wofsy Women’s HIV Study, Northern California CRS (Bradley Aouizerat, Phyllis Tien, and Jennifer Price), U01-HL146242; Los Angeles CRS (Roger Detels), U01-HL146333; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146205; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-HL146203; Pittsburgh CRS (Jeremy Martinson and Charles Rinaldo), U01-HL146208; UAB-MS CRS (Mirjam-Colette Kempf, Jodie Dionne-Odom, and Deborah Konkle-Parker), U01-HL146192; UNC CRS (Adaora Adimora), U01-HL146194. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI) , with additional co-funding from the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD) , National Institute On Aging (NIA) , National Institute Of Dental & Craniofacial Research (NIDCR) , National Institute Of Allergy And Infectious Diseases (NIAID) , National Institute Of Neurological Disorders And Stroke (NINDS) , National Institute Of Mental Health (NIMH) , National Institute On Drug Abuse (NIDA) , National Institute Of Nursing Research (NINR) , National Cancer Institute (NCI) , National Institute on Alcohol Abuse and Alcoholism (NIAAA) , National Institute on Deafness and Other Communication Disorders (NIDCD) , National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) , National Institute on Minority Health and Health Disparities (NIMHD) , and in coordination and alignment with the research priorities of the National Institutes of Health, Office of AIDS Research (OAR) . MWCCS data collection is also supported by UL1-TR000004 ( UCSF CTSA ), P30-AI-050409 ( Atlanta CFAR ), P30-AI-050410 ( UNC CFAR ), and P30-AI-027767 ( UAB CFAR ).

Keywords

HIV/AIDS
Loneliness
Older men who have sex with men
Resilience
Social bonding
Social cohesion
Social environment
Social support

ASJC Scopus subject areas

Health(social science)
History and Philosophy of Science

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.socscimed.2021.113711

Cite this

De Jesus, M., Ware, D., Brown, A. L., Egan, J. E., Haberlen, S. A., Palella, F. J., Detels, R., Friedman, M. R., & Plankey, M. W. (2021). Social-environmental resiliencies protect against loneliness among HIV-Positive and HIV- negative older men who have sex with men: Results from the Multicenter AIDS Cohort Study (MACS). Social Science and Medicine, 272, Article 113711. https://doi.org/10.1016/j.socscimed.2021.113711

@article{84c9e7500ba843f2b769a9037f140d39,

title = "Social-environmental resiliencies protect against loneliness among HIV-Positive and HIV- negative older men who have sex with men: Results from the Multicenter AIDS Cohort Study (MACS)",

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.",

keywords = "HIV/AIDS, Loneliness, Older men who have sex with men, Resilience, Social bonding, Social cohesion, Social environment, Social support",

author = "{De Jesus}, Maria and Deanna Ware and Brown, {Andre L.} and Egan, {James E.} and Haberlen, {Sabina A.} and Palella, {Frank Joseph} and Roger Detels and Friedman, {M. Reuel} and Plankey, {Michael W.}",

note = "Publisher Copyright: {\textcopyright} 2021 Elsevier Ltd",

year = "2021",

month = mar,

doi = "10.1016/j.socscimed.2021.113711",

language = "English (US)",

volume = "272",

journal = "Social Science and Medicine",

issn = "0277-9536",

publisher = "Elsevier Ltd",

}

De Jesus, M, Ware, D, Brown, AL, Egan, JE, Haberlen, SA, Palella, FJ, Detels, R, Friedman, MR & Plankey, MW 2021, 'Social-environmental resiliencies protect against loneliness among HIV-Positive and HIV- negative older men who have sex with men: Results from the Multicenter AIDS Cohort Study (MACS)', Social Science and Medicine, vol. 272, 113711. https://doi.org/10.1016/j.socscimed.2021.113711

TY - JOUR

T1 - Social-environmental resiliencies protect against loneliness among HIV-Positive and HIV- negative older men who have sex with men

T2 - Results from the Multicenter AIDS Cohort Study (MACS)

AU - De Jesus, Maria

AU - Ware, Deanna

AU - Brown, Andre L.

AU - Egan, James E.

AU - Haberlen, Sabina A.

AU - Palella, Frank Joseph

AU - Detels, Roger

AU - Friedman, M. Reuel

AU - Plankey, Michael W.

PY - 2021/3

Y1 - 2021/3

N2 - 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.

AB - 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.

KW - HIV/AIDS

KW - Loneliness

KW - Older men who have sex with men

KW - Resilience

KW - Social bonding

KW - Social cohesion

KW - Social environment

KW - Social support

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Social-environmental resiliencies protect against loneliness among HIV-Positive and HIV- negative older men who have sex with men: Results from the Multicenter AIDS Cohort Study (MACS)

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UN SDGs

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