Distinct Coping Combinations are Associated with Depression and Support Service Utilization in Men who have Sex with Men Living with HIV.

Abstract

Stigma and stress may place HIV-positive men who have sex with men (HIV+ MSM) at risk for depression. Additionally, HIV+ MSM might utilize multiple HIV-related services as a way to gain support for, and more effectively manage, HIV-related stressors. Although prior research has demonstrated that depression severity and utilizing support services are associated with functional or dysfunctional coping strategies, researchers have not investigated the impact of different coping combinations-specifically, the concurrent use of functional and dysfunctional strategies-in this population. Thus, we explored (1) how items on one measure of coping, the Brief COPE, capture HIV-related coping of HIV+ MSM using Principal Components Analysis, (2) how HIV+ MSM's coping groups into unique combinations, and (3) how these coping combinations relate to depression and the scope of HIV-related support service utilization. Our sample consisted of 170 HIV+ MSM engaged with medical care. Results indicated the use of both functional and dysfunctional coping strategies. Unique combinations of functional and dysfunctional strategies showed differential associations with depression and the extent of HIV-related support service utilization. Specifically, individuals who engaged in low levels of both functional and dysfunctional coping, compared to individuals who more frequently engaged in functional coping strategies, were significantly less likely to utilize a range of critical HIV-related services. Individuals who reported frequent use of dysfunctional coping strategies, regardless of functional coping strategy use, reported higher levels of depression. Therefore, providers should continue to focus more closely on identifying functional coping strategies and reducing dysfunctional coping when working with HIV+ MSM.