Understanding the role of social support and depression among women and MSM living with and without HIV in the MACS/WIHS combined cohort study

Although virally suppressive antiretroviral therapy has transformed HIV into a chronic, manageable condition, people living with HIV continue experiencing elevated depression rates. This study investigated differences in social support and depressive symptoms between men who have sex with men and women, both living with and without HIV. Using data from the Multicenter AIDS Cohort Study/Women’s Interagency HIV Study Combined Cohort Study (N = 2,537), depressive symptoms were evaluated via the Center for Epidemiologic Studies Depression Scale and social support via the modified Medical Outcomes Study Social Support Survey. Regression models adjusted for income, age, race, ethnicity, and HIV serostatus. No significant differences between MSM and women in levels of total social support (p = 0.657), instrumental support (p = 0.307), or emotional support (p = 0.901) were found. Women reported significantly higher levels of depressive symptoms than MSM (p = 0.046). Total, instrumental, and emotional support showed strong negative associations with depressive symptoms (p < 0.001). Interaction models revealed that the protective buffering effect of support appeared consistently across groups. Targeted clinical interventions and longitudinal research are urgently needed to bolster emotional and instrumental support systems, particularly for women and lower-income individuals facing disproportionately elevated depression risks.