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The Moderating Role of Social Support and HIV Stigma on the Association Between Depression and ART Adherence Among Young Thai Men Who Have Sex with Men

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Abstract

In Thailand, antiretroviral therapy (ART) programs still have difficulties reaching and promoting adherence among a key population - young men who have sex with men (YMSM) living with HIV. As such, we sought to examine potential psychosocial barriers that may contribute to suboptimal levels of ART adherence for this population. Data were drawn from a study of 214 YMSM living with HIV from Bangkok, Thailand. Linear regression models tested the association between depression and ART adherence, and whether social support and HIV-related stigma moderated that relationship. Multivariable models demonstrated social support was significantly associated with higher levels of ART adherence, and that there was a three-way interaction between depression, social support, and HIV-related stigma on ART adherence. These results further our understanding of the role of depression, stigma, and social support in ART adherence among Thai YMSM living with HIV, and that additional supports for YMSM with depression and HIV-related stigma are needed.

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Data Availability

The datasets generated and analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Acknowledgements

We thank all study participants for their willingness to participate, and all study staff for their contribution. Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under award number R21 AI125042 and materials for this research project was funded by Mahidol University. Keith J. Horvath, Linda Mireles, and Stephanie Meyers-Pantele were supported through NIDA grant R01 DA039950. Additionally, Keith Horvath and Linda Mireles were supported through NICHD grant U19 HD089881 and Stephanie Meyers-Pantele was supported through NIDA grants T32 DA023356 and K01 DA055983. Thomas E. Guadamuz, Worawalan Waratworawan, and Yamol Kongjareon were supported by NIMH Grant R01 MH119015.

Funding

Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Number R21 AI125042 and materials for this research project was funded by Mahidol University. Keith J. Horvath, Linda Mireles, and Stephanie Meyers-Pantele were supported through NIDA grant R01 DA039950. Additionally, Keith Horvath and Linda Mireles were supported through NICHD grant U19 HD089881 and Stephanie Meyers-Pantele was supported through NIDA grants T32 DA023356 and K01 DA055983. Thomas E. Guadamuz, Worawalan Waratworawan, and Yamol Kongjareon were supported by NIMH Grant R01 MH119015.

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Authors and Affiliations

  1. Department of Psychology, San Diego State University, San Diego, CA, USA

    Linda Mireles, Keith J. Horvath & Stephanie A. Meyers-Pantele

  2. Center of Excellence in Research on Gender, Sexuality and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand

    Thomas E. Guadamuz, Worawalan Waratworawan & Yamol Kongjareon

  3. Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand

    Thomas E. Guadamuz & Worawalan Waratworawan

  4. John F. Kennedy School of Government, Harvard University, Cambridge, MA, USA

    Thomas E. Guadamuz

  5. Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, San Diego, CA, USA

    Stephanie A. Meyers-Pantele

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  1. Linda Mireles
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Contributions

Linda Mireles: Conceptualization, Formal Analysis, Validation, Writing – Original Draft Preparation. Keith Horvath: Conceptualization, Resources, Supervision, and Writing – Reviewing and Editing. Thomas Guadamuz: Project Administration, Methodology, Resources, Investigation, and Writing – Reviewing and Editing. Worawalan Waratworawan: Project Administration, Methodology, Resources, Investigation, and Writing – Reviewing and Editing. Yamol Kongjareon: Project Administration, Methodology, Resources, Investigation, and Writing – Reviewing and Editing. Stephanie Meyers-Pantele: Conceptualization, Supervision, Validation, and Writing – Reviewing and Editing.

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Correspondence to Thomas E. Guadamuz.

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All study procedures were approved by the Mahidol University IRB.

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Mireles, L., Horvath, K.J., Guadamuz, T.E. et al. The Moderating Role of Social Support and HIV Stigma on the Association Between Depression and ART Adherence Among Young Thai Men Who Have Sex with Men. AIDS Behav 27, 2959–2968 (2023). https://doi.org/10.1007/s10461-023-04018-y

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