Leveraging Social Networks to Reduce Depression and Improve Treatment Adherence Among HIV-positive Men Who Have Sex With Men

Background: Depression among HIV-positive men who have sex with men (MSM) is a major barrier to HIV treatment adherence. Understanding the structure and composition of the social networks of HIV-positive MSM may be useful in the development of social network interventions to reduce depression and increase treatment adherence for this population.

Methods: HIV-positive MSM (N=136) were recruited from social service agencies throughout Los Angeles County and invited to participate in a cross-sectional social network interview. Depression was assessed using the Center for Epidemiological Studies Depression Scale (α=0.83). Multivariate associations between treatment adherence (using the 14-item ACTG adherence scale, α=0.89), depression, and social network characteristics were analyzed using generalized linear modeling with Gaussian distribution in SAS 9.4 adjusting for age and race/ethnicity.

Results: Participants had a mean age of 46.2 (SD=9.9) and were predominately Latino (50.7%) or African American (29.4%). Nearly two-thirds experienced significant depressive symptoms (61.5%). Participant’s social networks were comprised of friends (46.9%), family members (21.3%), social service providers (10.7%), medical professionals (5.8%) and primary romantic partners (3.4%). Greater depressive symptoms (b=0.05, p<0.05) and African American race (b=0.82, p<0.05) were associated with lower treatment adherence. Less than one fifth of network alters reminded participants to take their HIV medications (18.7%).

Conclusions: Despite the diversity of HIV-positive MSM’s social networks, few network members provide treatment adherence assistance. Leveraging supportive network members may improve health outcomes. Future research on the feasibility and acceptability of network interventions with this population are needed.