Social Isolation and Frailty Among Older People Living With HIV in China: Mediation Effects of Psychological Distress

To determine whether psychological distress mediates the relationship between social isolation and frailty among older people living with HIV (PLWH) in China. A quantitative cross-sectional study was conducted. A convenience sample of 342 eligible older PLWH were identified between December 2022 and October 2023. Data were collected through in-person surveys and structured questionnaires designed to collect data on sociodemographic characteristics, social isolation, frailty, and psychological distress with standard measures, including the Tilburg Frailty Indicator, Lubben Social Network Scale-6, and Distress Thermometer. Overall prevalence of major variables among participants was reported as follows: social isolation (57.3%), frailty (39.5%), and psychological distress (25.8%). Mediation analysis showed that an association between social isolation and frailty was mediated by psychological distress. Psychological distress partially mediated the relationship between social isolation and frailty, accounting for 30.4% of the total effect. Higher levels of social isolation and greater levels of psychological distress may be significant risk factors for frailty among older PLWH. Levels of social isolation influence frailty directly and indirectly through a psychological distress pathway.