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Is Social Isolation Related to Emotion Dysregulation and Retention in Care Among Older Persons Living with HIV?

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Abstract

Retention in care is important in managing HIV among older persons living with HIV (PLWH). We used Theory of Loneliness—loneliness affects emotion-regulatory processes which lead to dysfunctional health behaviors—to test whether social isolation is related to retention in care either directly or indirectly through emotion dysregulation in older PLWH (≥ 50 years of age; N = 144). Retention in care was defined as the proportion of attended scheduled medical visits; visit data were collected prospectively over 12 months from electronic medical records. Self-reported social isolation, emotion dysregulation, and covariates were assessed cross-sectionally at baseline. Most participants were male (60%), African American/Black (86%), and single (59%); 56% were optimally retained in care. Retention was related to monthly income, CD4 + T cell count, and drug use with no direct or indirect effects of social isolation on retention in care. Socioeconomic and behavioral vulnerabilities are closely related to retention in care among older PLWH.

Resumen

Retención en atención médica es importante para el manejo de VIH con personas mayores que viven con VIH (PMVV). Nosotros usamos la Teoría de Soledad- soledad afecta los procesos que regulan emociones y crea comportamientos de salud disfuncionales- para probar si aislamiento social está asociado directamente o indirectamente con la retención en atención médica por desregular emociones en PMVV (≥ 50 años de edad; N = 144). Retención en atención médica fue definido por la proporción de visitas médicas programadas y atendidas; y los datos de visitas atendidas que fueron programadas fueron recopilados prospectivamente por 12 meses de archivos médicos electrónicos. Aislamiento social auto-reportado, desregulación emocional, y covariables fueron evaluados transversalmente de la línea de base. La mayoría de los participantes fueron masculinos (60%), negros/americanos africanos (86%) y solteros (59%); 56% de nuestra muestra fueron retenidos optimamente en atención médica. Retención en atención médica fue asociada con ingresos mensuales, el conteo de linfocitos cd4 + , y el consumo de drogas ilegales; no encontramos efectos directos ni indirectos del aislamiento social a la retención en atención médica. Vulnerabilidades socioeconómicas y de comportamiento están vinculados estrechamente a la retención en atención médica para PMVV.

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Acknowledgements

This work was supported by the National Institute of Nursing Research of the National Institutes of Health under the following Award Numbers: F31NR015975, T32NR014205. We would like to thank Dr. Ashley Anderson, PhD, RN, and Kristine Kulage, MA, MPH, for their constructive feedback and technical assistance with editing the manuscript.

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Authors and Affiliations

  1. School of Nursing, Columbia University, 560 West 168th Street, New York, NY, 10032, USA

    Moka Yoo-Jeong

  2. Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA

    Regine Haardörfer

  3. Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA

    Marcia Holstad, Kenneth Hepburn & Drenna Waldrop-Valverde

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  1. Moka Yoo-Jeong
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Correspondence to Moka Yoo-Jeong.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Study protocol was approved by the Institutional Review Board and by the recruiting clinic’s research oversight committee.

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Informed consent was obtained from all individual participants included in the study. Individuals were compensated for their participation in the study.

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Yoo-Jeong, M., Haardörfer, R., Holstad, M. et al. Is Social Isolation Related to Emotion Dysregulation and Retention in Care Among Older Persons Living with HIV?. AIDS Behav 25, 171–181 (2021). https://doi.org/10.1007/s10461-020-02957-4

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