Differentiating the effects of positive and negative social transactions in HIV illness

Abstract

This study examines the role of positive and negative social transactions in HIV illness as influenced by depressive symptoms and alcohol comorbidities. Our model distinguishes between confidant and broader network transactions, and between overt criticism and undermining transactions. This is a sample of 121 Human Immunodeficiency Virus positive (HIV+) patients from two urban infectious disease clinics surveyed to assess the quality of both the confidant relationship and the broader social network, depressive symptoms, alcohol abuse, and HIV health symptoms. In hierarchical regression analyses, criticism from the broader network was related to symptoms of alcohol abuse, whereas disappointment with transactions from the broader network were more often associated with depressive symptoms. Negative confidant relationships and negative network transactions were both associated with greater severity of HIV illness, and were predictive of subsequent emergency room utilization. This study illustrates the value of distinguishing both the types of negative social transactions and their sources. Future research should examine the significant roles that criticism and undermining negative social network transactions appear to play in HIV illness and its comorbid symptoms. © 2000 John Wiley & Sons, Inc.