Mediating roles of social support in lives of men who have sex with men living with HIV

Objectives: This study examined the mediating role of social support between distal minority stressors, psychological states, and health-related quality of life (HRQoL) among men who have sex with men (MSM) living with HIV in the United States. We also investigated the role of social support in the relationship between resilient coping and mental HRQoL. Method: A prospective cohort of 263 MSM living with HIV consisted of 25.8% reported and classified as Asian and Pacific Islanders, 36.9% as Black, 27.7% as White, and 9.2% as others, with a mean age at 53.4 years (SD= 13.6) in Hawai’i and Philadelphia were assessed at baseline and three consecutive follow-ups at 6, 12, and 18 months. Generalized linear mixed models and causal mediation analyses were used to examine the relationships and mediating roles of social support between psychosocial factors and mental/physical HRQoL. Results: Discrimination, early trauma, perceived stress, depression, and anxiety were associated with poorer mental HRQoL, whereas resilient coping and social support were associated with better mental HRQoL. Anxiety, depression, and perceived stress were associated with poorer physical HRQoL, and social support was associated with better physical HRQoL. Social support mediated the deleterious and protective effects of discrimination, proportion mediated (pm) = 27%, early emotional trauma (pm = 25.9%), and resilient coping (pm= 19.9%) on mental HRQoL and the negative impacts of anxiety (pm =12.1%) and perceived stress (pm = 5.8%) on physical HRQoL. Conclusion: Promoting adaptive coping strategies and fostering social support may lead to sustainable improvements in the well-being of MSM living with HIV infection.