Social support of people with HIV/AIDS: the Social Determinants of Health Model

This was a cross-sectional study conducted in 2015 in an infectious disease outpatient clinic. The sample was made up of 116 people with HIV/AIDS. The data was collected through interviews, using a sociodemographic form and a social support scale. The data was analyzed using descriptive statistics, and Student’s t-tests and Mann-Whitney tests were performed to determine the association between social support and the social determinants of health.

Results:

Total social support was satisfactory, emotional support was influenced by smoking (p=0.0432) and instrumental support, by the number of people in the household (p=0.0003). The main source of instrumental and emotional support was relatives living outside the household, corresponding to 66.7% and 56.1%, respectively.

Conclusion:

It was found that smokers havelower emotional support and people living alone received less instrumental support.

Descriptors:
HIV; Acquired Immunodeficiency Syndrome; Social Support; Social Determinants of Health; Public Health

Layers of the Social Determinants of Health Model	Total Social Support		Total	p value^* * Chi-square test for independent variables
	Satisfactory	Unsatisfactory	n (%)
	n(%)	n(%)
1. Individual determinants
Sex
Male	35 (30.1)	17 (14.7)	52 (44.8)	0.4800
Female	48 (41.4)	16 (13.8)	64 (55.2)
Age group (in years)
≤ 40	51 (44.0)	18 (15.5)	69 (59.5)	0.6359
> 40	32 (27.5)	15 (12.9)	47 (40.5)
Skin color
Brown	52 (44.8)	16 (13.8)	68 (58.6)	0.2346
Other	31 (26.7)	17 (14.7)	48 (41.4)
2. Proximal determinants
Sexual orientation
Heterosexual	60 (51.7)	25 (21.6)	85 (73.3)	0.8821
Homosexual / Bisexual	23 (19.8)	8 (6.9)	31 (26.7)
Physical exercise
Yes	45 (38.8)	12 (10.3)	57 (49.1)	0.1261
No	38 (32.8)	21 (18.1)	59 (50.9)
Use of alcohol
Yes	41 (35.3)	12 (10.4)	53 (45.7)	0.2869
No	42 (36.2)	21 (18.1)	63 (54.3)
Use of tobacco
Yes	10 (8.6)	11 (9.5)	21 (18.1)	0.0155
No	73 (62.9)	22 (19.0)	95 (81.9)
Use of illicit drugs
Yes	3 (2.6)	3 (2.6)	6 (5.2)	0.4611
No	80 (69.0)	30 (25.8)	110 (94.8)
3. Influence of social networks
Marital Status
Single	32 (27.6)	13 (11.2)	45 (38.8)	0.9749
Married	37 (31.9)	15 (12.9)	52 (44.8)
Other	14 (12.1)	5 (4.3)	19 (16.4)
Children
Yes	34 (29.3)	16 (13.8)	50 (43.1)	0.596
No	49 (42.2)	17 (14.7)	66 (56.9)
Number of people in the household
1	13 (11.2)	8 (6.9)	21 (18.1)	0.414
≥2	70 (60.3)	25 (21.6)	95 (81.9)
Religion
Professes	75 (64.7)	30 (25.9)	105 (90.6)	1.0000
Does not profess	8 (6.8)	3 (2.6)	11 (9.4)
4. Intermediate determinants
Household income (Minimum wage)
< 3	55 (47.4)	22 (19.0)	77 (66.4)	1.0000
≥3	28 (24.1)	11 (9.5)	39 (33.6)
Years of education
≤ 9	29 (25.0)	10 (8.6)	39 (33.6)	0.7955
> 9	54 (46.6)	23 (19.8)	77 (66.4)
Employment status
Active	44 (37.9)	17 (14.7)	61 (52.6)	1.0000
Inactive	39 (33.6)	16 (13.8)	55 (47.4)

Layers of the Social Determinants of Health Model	Types of Social Support
	Instrumental			Emotional
	Mean	SD	p value	Mean	SD	p value
1. Individual determinants
Sex
Male	3.7	0.8	0.3638^† † Student's t test;	4.0	0.8	0.4330^‡ ‡ Mann-Whitney test;
Female	3.6	0.8	0.3638^† † Student's t test;	3.8	0.9	0.4330^‡ ‡ Mann-Whitney test;
Age group (in years)
≤ 40	3.7	0.7	0.5875^‡ ‡ Mann-Whitney test;	3.9	0.9	0.7818^‡ ‡ Mann-Whitney test;
> 40	3.7	1.0		3.9	0.9	0.7818^‡ ‡ Mann-Whitney test;
Skin color
Brown	3.8	0.8	0.1377^‡ ‡ Mann-Whitney test;	3.9	0.9	0.5005^‡ ‡ Mann-Whitney test;
Other	3.6	0.7		3.8	0.9
2 Proximal determinants
Sexual orientation
Heterosexual	3.7	0.8	0.827^‡ ‡ Mann-Whitney test;	3.8	0.9	0.1991^‡ ‡ Mann-Whitney test;
Homosexual / Bisexual	3.7	0.8		4.1	0.7
Physical exercise
Yes	3.8	0.7	0.1782^‡ ‡ Mann-Whitney test;	4.0	0.9	0.2522^‡ ‡ Mann-Whitney test;
No	3.5	0.9		3.8	0.9
Use of alcohol
Yes	3.7	0.7	0.8744^‡ ‡ Mann-Whitney test;	4.0	0.7	0.6792^‡ ‡ Mann-Whitney test;
No	3.6	0.8		3.8	1.0
Use of tobacco
Yes	3.3	1.0	0.0576^‡ ‡ Mann-Whitney test;	3.6	0.8	0.0432^‡ ‡ Mann-Whitney test;
No	3.7	0.7		4.0	0.8
Use of illicit drugs
Yes	3.0	1.0	0.1248^‡ ‡ Mann-Whitney test;	3.5	0.9	0.3332^‡ ‡ Mann-Whitney test;
No	3.7	0.8		3.9	0.9
3. Influence of social networks
Marital Status
Single	3.7	0.8	0.5722^‡ ‡ Mann-Whitney test;	4.0	0.8	0.3463^‡ ‡ Mann-Whitney test;
Married	3.7	0.8		3.8	0.9
Children
Yes	3.6	0.8	0.4495^‡ ‡ Mann-Whitney test;	4.0	0.9	0.5064^‡ ‡ Mann-Whitney test;
No	3.7	0.8		3.8	0.8
Number of people in the household
1	3.1	0.6	0.0003^‡ ‡ Mann-Whitney test;	4.0	0.8	0.5877^‡ ‡ Mann-Whitney test;
≥2	3.8	0.8		3.9	0.9
Religion
Professes	3.7	0.8	0.8135^‡ ‡ Mann-Whitney test;	3.9	0.9	0.3477^‡ ‡ Mann-Whitney test;
Does not profess	3.7	0.8		4.1	0.7
4. Intermediate determinants
Household income (Minimum wage)^§ § At the time of the study, the minimum wage was BRL 788, equivalent to USD 251.77.
< 3	3.6	0.8	0.4161^‡ ‡ Mann-Whitney test;	3.9	0.8	0.5882^‡ ‡ Mann-Whitney test;
≥3	3.8	0.8		3.9	0.9
Years of education
≤ 9	3.7	0.9	0.9398^† † Student's t test;	3.8	0.9	0.3168^‡ ‡ Mann-Whitney test;
> 9	3.7	0.8		3.9	0.9
Employment status
Active	3.8	0.8	0.1605^† † Student's t test;	4.0	0.9	0.2802^‡ ‡ Mann-Whitney test;
Inactive	3.6	0.8		3.8	0.8

Source of support	Social support
Source of support	Instrumentaln (%)	Emotionaln (%)
Spouse/partner	53 (46.5)	57 (50.0)
Relative living in the same household	46 (40.6)	44 (38.6)
Relative not living in the same household	76 (66.7)	64 (56.1)
Friend(s)	35(30.7)	63 (55.3)
Boss/co-worker	2 (1.8)	4 (3.5)
Neighbor(s)	5 (4.4)	4 (3.5)
Health professionals	10 (8.8)	19 (16.7)
Other	3 (2.6)	3 (2.6)

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[1] CORRESPONDING AUTHOR: Vanessa da Frota Santos E-mail: doutorandavanessasantos@outlook.com