In late stages of HIV infection, the disease progresses more slowly in gay and bisexual men who have supportive social relationships, researchers have found, but in earlier stages of infection social support appears linked with faster HIV progression.
Gregory E. Miller, PhD, and Steve W. Cole, PhD, of the University of California, Los Angeles, drew their conclusions after reviewing 10 studies of HIV progression involving nearly 1,300 people. Most subjects were gay or bisexual men, but some studies also examined heterosexuals, lesbians, hemophiliacs, and IV drug users.
"The studies reviewed here are among the first to demonstrate that the presence of supportive relationships may have negative implications for physical health," the researchers write in Annals of Behavioral Medicine (Vol. 20, No. 3). "The different effects observed across patient groups and disease stages may help explain when social relationships exert protective effects on health and when they do not."
For gay and bisexual men with HIV, having supportive relationships was associated with lower levels of CD4 T lymphocytes, a key marker of immune system function, and tended to speed the appearance of AIDS-related conditions.
The same kind of relationships, however, were associated with the opposite effect, slowed progression, among gay and bisexual men in later stages of HIV infection. The effects of these relationships remained largely positive for others with HIV at every stage of infection.
Miller and Cole note that while social support has generally been thought to have a positive influence on health, "some investigators have proposed that stressful aspects of social relationships can heighten vulnerability to disease or interfere with recovery from it, but little research has emerged to support these assertions." Miller, now at Carnegie Mellon University and the Western Psychiatric Institute and Clinic in Pittsburgh, and Cole outline a number of potential reasons for the negative effect of social relationships among gay and bisexual men in the early stages of HIV infection, among them:
- People with large social networks may engage in more high-risk sexual
behavior than those who are socially isolated. They also may be more likely to
smoke, drink, or engage in other behavior that compromises their health.
Gay and bisexual men with large social networks may know greater numbers of people who have died from AIDS. Bereavement is known to alter immune function.
- Similarly, these men are also more likely to be caring for others with HIV, potentially increasing their stress levels and dampening their resistance to HIV.
Annals of Behavioral Medicine is the official peer-reviewed publication of The Society of Behavioral Medicine. For information about the journal, contact editor Arthur Stone, PhD, 516-632-8833.