Patterns of Social Engagement and Associations with Depression, Loneliness and Stigma in People Living with HIV

People living with HIV (PWH), more than half of whom are age 50 years and older, experience a high prevalence of multiple chronic conditions (MCC) and fragile social networks. Although social engagement can be protective against detrimental physical, cognitive, and mental health outcomes, there is limited evidence about older PWH's social engagement and associated factors in engaging with family, friends and the community. This study examined the state of social engagement in a population of older PWH, using the 13-item Frequency of Leisure Activities Scale from the Research on Older Adults with HIV (ROAH 2.0) study conducted in New York City. We performed factor and regression analyses to characterize social engagement activities and examine their relationships with MCC, AIDS diagnosis, social vulnerability index (SVI), financial strain, loneliness, HIV-related stigma, and depressive symptoms, controlling for demographic factors. PWH (n = 349, age range = 50-84) were less engaged in social (Mean = 1.31; SD = 0.71) and cultural-physical (Mean = 1.55; SD = 0.78) than in media-based activities (Mean = 3.09; SD = 0.72), with Omega reliability estimated at 0.716, 0.651, and 0.620 respectively. Financial strain, AIDS diagnosis, greater HIV-related stigma, loneliness, and depressive symptoms were associated with low social activity engagement (F(6, 316) = 9.87, p < 0.001). High SVI score and financial strain were negatively associated with engagement in cultural-physical activities (F(5, 317) = 2.61, p < 0.001). High levels of depressive symptoms were negatively associated with engagement in media-based activities (F(4, 318) = 5.88, p < 0.001). The findings provide foundations for future research to improve our understanding of social engagement in older PWH and help create interventions that could target different dimensions of social engagement to improve mental health outcomes in this population.