Social relationships and the progression of human immunodeficiency virus infection: A review of evidence and possible underlying mechanisms

We review studies examining the quality and quantity of social relationship s as potential risk factors for differential progression of human immunodef iciency virus (HIV) infection. Several well-conducted prospective studies s uggest that the health effects associated with the presence of supportive s ocial relationships vary according to disease stage and mode of transmissio n. For gay or bisexual males in the early stages of infection, the presence of supportive social relationships appears to be a risk factor for acceler ated disease progression. For individuals in the later stages of infection and those who acquire HIV via intravenous drug use or transfusion supportiv e social relationships appear to be associated with health protective effec ts similar to those observed in other disease settings. We consider a varie ty of potential explanations for accelerated disease progression in gay men with extensive networks of personal relationships.