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Mediating Effects of Depressive Symptoms on Perceived Social Support and HIV Disclosure: Assessing Moderation by Sex

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Abstract

People living with HIV may decide to disclose their HIV-positive status after considering the benefits and costs. Studies have shown associations between perceived social support, depressive symptoms and HIV disclosure among men and women; however, research assessing the mediating pathway among these variables and the associated disparities by sex are lacking. Therefore, the aims of this study were to determine the association between perceived social support from family and friends and HIV disclosure to sexual partners; assess the mediating effects of depressive symptoms; and examine the disparities by sex. Participants included 147 men and 115 women living with HIV who took part in a disclosure intervention study. Mediation analyses were conducted to determine the direct and indirect associations between perceived social support from family and friends, depressive symptoms, and disclosure behavior. Depressive symptoms mediated the association between perceived social support (from family: β = 0.103, p = 0.019; and from friends: β = 0.111, p = 0.009) and HIV disclosure to sexual partners, specifically among women. However, these pathways were not statistically significant among men. Women living with HIV may benefit from two types of interventions: (1) Disclosure to sexual partners interventions, which aim to accentuate perceived social support from family and friends through attenuating depressive symptoms; and (2) Social support interventions, which may increase disclosure to sexual partners via reducing depressive symptoms.

Resumen

Las personas viviendo con el VIH pueden decidir a revelar su estado del VIH después de considerar los beneficios y los costos. Las investigaciones han demostrado que existen las asociaciones entre la percepción del apoyo social, los síntomas depresivos y la revelación del estado del VIH para los hombres y las mujeres. Sin embargo, las investigaciones que evalúan el rol mediador de los síntomas depresivos entre la percepción del apoyo social y la revelación del estado de VIH, y las disparidades asociadas por el sexo son limitadas. Por lo tanto, los objetivos de esta investigación fueron determinar la asociación entre la percepción del apoyo social de la familia y los amigos, y la revelación del estado de VIH a sus parejas sexuales; evaluar los efectos mediados de los síntomas depresivos; y examinar las disparidades por el sexo. Los participantes fueron 147 hombres y 115 mujeres viviendo con el VIH que participaron en una investigación del revelamiento del estado de VIH. Los análisis mediadores se llevaron a cabo a determinar las asociaciones directos e indirectos entre el apoyo social de la familia y los amigos, los síntomas depresivos, y la revelación del estado de VIH. Los síntomas depresivos tuvieron un rol mediador entre el apoyo social (de la familia: β = 0.103, p = 0.019; y de los amigos: β = 0.111, p = 0.009) y la revelación del estado de VIH a sus parejas sexuales, específicamente entre las mujeres. Sin embargo, este efecto indirecto no tenía significancia estadística entre los hombres. Las mujeres viviendo con el VIH puede beneficiarse de dos tipos de intervenciones: 1) Las intervenciones que se enfoquen en la revelación del estado del VIH a las parejas sexuales que se enfoquen en acentuar el apoyo social de la familia y los amigos por atenuar los síntomas depresivos; y 2) Las intervenciones del apoyo social que incrementen la revelación del estado del VIH a las parejas sexuales por reducir los síntomas depresivos.

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Acknowledgements

This study was funded by the National Institute of Mental Health (R01MH097486) awarded to the second author (JMS). We would like to thank the individuals who participated in this study.

Funding

This study was funded by the National Institute of Mental Health (R01MH097486).

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Discovery I, 435C, Columbia, SC, 29208, USA

    Monique J. Brown

  2. South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Monique J. Brown

  3. College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA

    Julianne M. Serovich & Tanja C. Laschober

  4. Division of Biology and Medicine, Brown University, Providence, RI, USA

    Judy A. Kimberly

  5. Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA

    Celia M. Lescano

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  1. Monique J. Brown
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  2. Julianne M. Serovich
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  3. Tanja C. Laschober
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  4. Judy A. Kimberly
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Correspondence to Monique J. Brown.

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MJB declares that she has no conflict of interest. JMS declares that she has no conflict of interest. TCL declares that she has no conflict of interest. JAK declares that she has no conflict of interest. CML declares that she has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Brown, M.J., Serovich, J.M., Laschober, T.C. et al. Mediating Effects of Depressive Symptoms on Perceived Social Support and HIV Disclosure: Assessing Moderation by Sex. AIDS Behav 23, 636–648 (2019). https://doi.org/10.1007/s10461-018-2369-x

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