Social Connectedness, Loneliness, and Health Among Aging Black Sexual Minority Men - Black gay men (BGM), who comprise a substantial proportion of people with HIV, show poor outcomes on multiple mental and physical health indicators that increase with age. Aging gay men and Black adults also show low social connectedness (loneliness and social isolation), which can lead to poor health outcomes. This application, submitted under PAR-21-350, proposes to use a longitudinal mixed methods social network study to examine how changes in loneliness and social isolation are related to changes in health and wellness among aging BGM, and what factors mediate and moderate these associations, following social isolation theories. The Specific Aims are to: (1) Test associations of longitudinal trajectories of social disconnectedness (loneliness, social isolation) with mental and physical health behaviors (healthcare engagement, adherence), quality of life, and chronic health conditions (including HIV-related outcomes) among aging BGM; (2) Examine regional, neighborhood, social network, and individual resilience and risk factors that may explain, buffer, or amplify impacts of social disconnectedness on health among BGM; and (3) Conduct and interpret qualitative and mixed methods analysis and describe next steps for feasible and acceptable interventions to increase positive social connections among aging BGM. We will recruit 400 BGM (200 with HIV, 200 without HIV) aged 40 and older, with a focus on high-priority jurisdictions for the US Ending the HIV Epidemic initiative in Southern California and the state of Alabama. Participants will be surveyed at baseline, 6-months, and 12-months; a subset of 80 participants will complete longitudinal in-depth interviews to explain quantitative ratings of loneliness and isolation, and connections and subgroups depicted on their social network diagram, as well as to suggest ideas for potential interventions to address social disconnectedness (e.g., social prescribing, including acceptable activities and groups). This research is Stage 0-1 along the NIH Stage Model for Behavioral Intervention Development, in which we are collecting basic data in order to generate ideas for intervention, which will be tested in future clinical trials. Information gained from this research will be broadly applicable to fostering healthy longevity for all aging Americans.
