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

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