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1994-10-25
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Document 2357
DOCN M94A2357
TI Is low social support a risk factor for subsequent HIV disease
progression? Vancouver Lymphadenopathy-AIDS Study Group.
DT 9412
AU Willoughby B; Hogg RS; Strathdee SA; Craib KJ; Zadra J; Montaner JS;
Schechter MT; BC Centre for Excellence in HIV/AIDS, Vancouver, Canada.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):322 (abstract no. PC0221). Unique
Identifier : AIDSLINE ICA10/94370218
AB OBJECTIVE: To determine whether measures of social support are
associated with progression of HIV disease progression in a prospective
cohort of homosexual men. METHODS: 357 subjects [133 seroprevalent (SP);
64 seroincident (SI); 160 seronegative (SN)] provided demographic and
social support data and laboratory specimens at two annual cycles (1992
& 1993), and were AIDS-free at the time CD4 counts were determined in
1992. Social support measures were network size (NSz) and a 26-item
Instrumental-Expressive Social Support Scale (IES). IES was coded 0
(rarely/never) vs. 1 (mostly/always) for each of the 26 items, and the
upper tertile of the summed IES score was used to categorize subjects as
high IES (hiIES) vs. low IES (loIES). NSz below the lowest tertile
differentiated between networks which were considered small (smNSz)
versus large (lgNSz). hiIES and smNSz indicate low social support.
ANCOVA were conducted adjusting for baseline CD4 counts and CDC stage in
1992, where the dependent variable was % of CD4 cells lost between 1992
and 1993. Chi-square tests compared progression to AIDS among subjects
with hiIES vs. loIES and smNSz vs. lgNSz. RESULTS: No differences
between HIV+ (N = 153) and SN (N = 160) individuals were found in change
in IES score or NSz between 92 and 93 (p = 0.279, and p = 0.377,
respectively). Among 197 HIV+ men at baseline in 1992, there were no
significant differences between hiIES vs. loIES subjects in mean CD4
counts, but those with high IES scores had slightly more symptoms. Even
after controlling for these baseline factors, hiIES subjects experienced
a greater mean % CD4 loss than loIES men (-19% vs. -7%; p = 0.034).
Similarly, smNSz subjects experienced a greater mean % CD4 loss than
lgNSz men (-19% vs. -8%; p = 0.043). AIDS progression was also
associated with hiIES. By 1993, more hiIES men developed AIDS than loIES
men whether they were at CDC stage 1 at baseline (15.4% vs 6.9%) or at
higher stages (30.8% vs 22.0%). CONCLUSIONS: Low social support may be
associated with subsequent CD4 cell loss and HIV disease progression
among homosexual men. Further prospective analyses are required to
determine the direction of causality between determinants of low social
support and faster progression to AIDS.
DE Cohort Studies Homosexuality Human HIV
Infections/IMMUNOLOGY/*PATHOLOGY/PSYCHOLOGY Leukocyte Count Male
Prognosis Prospective Studies Risk Factors *Social Support T4
Lymphocytes MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).