Equity of Social Support and Its Relationship with Depression, Anxiety, and Antiretroviral Medication Adherence Among Seroconcordant Dyads of HIV-positive African Americans and Their Informal Supporters

Abstract

Social support may be an important resource for those coping with stigmatized chronic illnesses, such as HIV/AIDS, as social support may buffer the deleterious impact of HIV-related distress (Derlega, Winstread, Oldfield, & Barbee, 2003; Stutterheim, Bos, Pryor, Brands, Liebregts, & Schaalma, 2011; Ueno & Adams, 2001). Yet little is known about characteristics of social support among HIV-positive patients in relationships with other HIV-positive individuals and whether there is an equivalent perception and provision of support between each patient in the relationship. To examine how equity of support within the dyad may contribute to nuances in social support, mental health outcomes, and treatment adherence among HIV-positive individuals, I recruited 34 dyads comprised of HIV-positive African Americans and their HIV-positive supporters to complete a survey with measures of perceived social support, equity of support, relationship factors such as perceived quality of the relationship, depression and anxiety, and treatment adherence. The results indicate that perceptions of greater perceived social support from one's dyadic partner was associated with fewer depressive or anxiety symptoms. Index patients and informal supporters' perceptions of source- specific social support were not related to index patients' past month medication adherence. Participants' own and dyad partners' perceptions of equity (i.e., deviation from equity) were not identified as significant predictors for any of the outcome variables. There was no evidence of significant partner effects for any of the study hypotheses. Thus, the results from this study may be most consistent with an actor-oriented model (Kenny & Cook, 1999), wherein the participants' outcomes are a function of the individuals' perceptions themselves, and their partners' perceptions have no effect on the individuals' outcomes. The results from this study indicate the protective effects of individuals' perceptions of being supported by a specific support person, generalized among a variety of relationships, on depressive and anxiety symptoms. Future research should explore the perceptions of support and the rules that may govern relationships among individuals in HIV-affected relationships to better understand the nuances in social support and their relation to mental health and treatment outcomes.