Social support, mental health needs, and HIV risk behaviors: a gender-specific, correlation study

Lin Fang,Deng-Min Chuang,Maria Al-Raes

doi:10.1186/s12889-019-6985-9

Abstract

BackgroundThe HIV/AIDS epidemic continues to threaten the health and wellbeing of millions in the United States and worldwide. Syndemic theory suggests that HIV/AIDS can cooccur with other afflictions. As close to 20% of US adults live with a mental health condition, it is critical to understand the correlation between HIV risk behaviors and mental health needs, as well as protective factors such as social support in intervening the association between mental distress and HIV risk behaviors. Furthermore, as past research has shown mixed results concerning the function of social support on HIV risks by gender, it is important to conduct a gender-specific analysis.MethodsTo assess the relationship between mental health needs, social support, and HIV risk behaviors, and to assess if social support can be a buffer, weakening the effect of mental health needs on HIV risk, in 2018, we analyzed representative, cross-sectional data from 2016 BRFSS collected from 33,705 individuals from four states in the United States, stratified by gender. Weighted logistic regression analyses, adjusted for age, race, marital status, education, and annual income, assessed the correlation between mental health needs, social support, and HIV risk behaviors. Furthermore, interaction analyses were performed to see if social support modifies the slope of mental health needs as a function of HIV risk behaviors.ResultsFor both genders, the odds of participating in HIV risk behaviors increase with mental health needs and decrease with the level of social support. Furthermore, social support mitigates the association between mental health needs and HIV risk behavior involvement for males, as males receiving high level of social support have least odds of HIV risk behaviors relative to males receiving low level of social support. Notably, for females, social support does not serve as a buffer against HIV risk behaviors when their mental health needs increase.ConclusionThe study contributes to the knowledge base of HIV prevention and highlights the important role of mental health and social support against HIV risk behaviors when developing gender-specific prevention strategies.

Highlights

The Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) epidemic continues to threaten the health and wellbeing of millions in the United States and worldwide
HIV risk behaviors are associated with greater mental health needs and lower level of perceived social support
Compared to their counterparts who did not have mental health needs in the past 30 days, males who did have mental health needs have a 49% odds increase in engaging in HIV risk behaviors, and females have a 93% odds increase. For both males and females, those who reported to have medium (males: adjusted odds ratio (AOR) = 0.54, 95% CI = 0.41, 0.70, p < .0001; females: AOR = 0.55, 95% CI, 0.41, 0.75, p < .0001) or high levels of social support are almost twice less likely to be involved in HIV risk behaviors

Summary

Introduction

The HIV/AIDS epidemic continues to threaten the health and wellbeing of millions in the United States and worldwide. Mental health problems and HIV risk behaviors are correlated among men who have sex with men [13,14,15,16,17,18,19,20], drug injection users [21, 22], female sex workers [23], immigrants [24, 25], transgender women [26], and in general population [27,28,29]. These studies indicate that people with mental health needs may have increased vulnerability to HIV risk behaviors

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Conclusion