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The impact of social support and partner relationship dynamics on engagement in HIV care and antiretroviral treatment adherence among MSM in Latin America

ABSTRACT In Latin America (LA), HIV prevalence among MSM is estimated at thirty times greater than in the general male population. Little is known about the role of social support or disclosure status in relation to the HIV care continuum among LA MSM. Using multivariable logistic generalized estimation equations, we assessed the impact of social support satisfaction and disclosure status on engagement in HIV care, ART initiation, and ART adherence with data from an online, multinational sample of HIV infected MSM in Latin America (N = 2,350). 80.0% were engaged in HIV care, 71% initiated ART, and among those, 37% reported missing at least one dose in the past month. In multivariable models, compared to being very satisfied with social support, being somewhat satisfied (aOR = 0.73, 95% CI 0.56, 0.95) or somewhat dissatisfied (aOR = 0.83, 95% CI 0.70, 0.98) were associated with reduced odds of reporting 100% ART adherence. Disclosure of status was associated with a greater odds of HIV care engagement (OR = 1.63, 95% CI 1.28, 2.07) and ART initiation (OR = 1.55, 95% CI 1.30, 1.84). Greater satisfaction with social support and comfort disclosing HIV status to these sources were associated with improved engagement in HIV care and greater initiation of ART among MSM in LA.