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Distinct Coping Combinations are Associated with Depression and Support Service Utilization in Men who have Sex with
Brian A Rood1, Elizabeth A McConnell2, David W Pantalone3
1Suffolk University.
Insights
HIV-positive men who have sex with men (HIV+ MSM) often use both helpful and unhelpful coping strategies. Combinations of these strategies impact depression and use of HIV services, highlighting the need for tailored support.
Area of Science:
- Psychiatry
- Public Health
- Behavioral Science
Background:
- Stigma and stress increase depression risk in HIV-positive men who have sex with men (HIV+ MSM).
- HIV+ MSM may use multiple services for managing HIV-related stressors.
- Coping strategies' impact on depression and service use in HIV+ MSM is not fully understood, especially combined coping patterns.
Purpose of the Study:
- To analyze how the Brief COPE captures HIV+ MSM coping mechanisms.
- To identify distinct combinations of coping strategies used by HIV+ MSM.
- To examine the relationship between these coping combinations, depression, and HIV service utilization.
Main Methods:
- Principal Components Analysis of Brief COPE items for HIV+ MSM.
- Latent class analysis to identify coping strategy combinations.
- Regression analyses to assess associations with depression and service use.
Main Results:
- Both functional and dysfunctional coping strategies were prevalent among HIV+ MSM.
- Unique combinations of coping strategies showed varied associations with depression and service use.
- Low use of both coping types was linked to reduced service utilization; high dysfunctional coping correlated with increased depression.
Conclusions:
- Coping strategy combinations significantly influence depression and service use in HIV+ MSM.
- Providers should identify and promote functional coping while mitigating dysfunctional strategies.
- Targeted interventions addressing specific coping patterns may improve outcomes for HIV+ MSM.
Abstract:
Stigma and stress may place HIV-positive men who have sex with men (HIV+ MSM) at risk for depression. Additionally, HIV+ MSM might utilize multiple HIV-related services as a way to gain support for, and more effectively manage, HIV-related stressors. Although prior research has demonstrated that depression severity and utilizing support services are associated with functional or dysfunctional coping strategies, researchers have not investigated the impact of different coping combinations-specifically, the concurrent use of functional and dysfunctional strategies-in this population. Thus, we explored (1) how items on one measure of coping, the Brief COPE, capture HIV-related coping of HIV+ MSM using Principal Components Analysis, (2) how HIV+ MSM's coping groups into unique combinations, and (3) how these coping combinations relate to depression and the scope of HIV-related support service utilization. Our sample consisted of 170 HIV+ MSM engaged with medical care. Results indicated the use of both functional and dysfunctional coping strategies. Unique combinations of functional and dysfunctional strategies showed differential associations with depression and the extent of HIV-related support service utilization. Specifically, individuals who engaged in low levels of both functional and dysfunctional coping, compared to individuals who more frequently engaged in functional coping strategies, were significantly less likely to utilize a range of critical HIV-related services. Individuals who reported frequent use of dysfunctional coping strategies, regardless of functional coping strategy use, reported higher levels of depression. Therefore, providers should continue to focus more closely on identifying functional coping strategies and reducing dysfunctional coping when working with HIV+ MSM.
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