Temporal association of pre-pandemic perceived social support with psychological resilience and mental well-being during the COVID-19 pandemic among people with a history of injection drug use

Eshan U Patel; Jacquie Astemborski; Kenneth A Feder; Jacqueline E Rudolph; Abigail Winiker; David W Sosnowski; Gregory D Kirk; Shruti H Mehta; Becky L Genberg

doi:10.1016/j.drugalcdep.2023.109802

Temporal association of pre-pandemic perceived social support with psychological resilience and mental well-being during the COVID-19 pandemic among people with a history of injection drug use

Drug Alcohol Depend. 2023 Mar 1:244:109802. doi: 10.1016/j.drugalcdep.2023.109802. Epub 2023 Feb 9.

Authors

Eshan U Patel¹, Jacquie Astemborski¹, Kenneth A Feder², Jacqueline E Rudolph¹, Abigail Winiker³, David W Sosnowski², Gregory D Kirk¹, Shruti H Mehta¹, Becky L Genberg⁴

Affiliations

¹ Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
² Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
³ Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
⁴ Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. Electronic address: bgenberg@jhu.edu.

Abstract

Background: There are limited data on whether modifiable social factors foster psychological resilience and mental well-being among people who use drugs following Big Events. We examined the temporal association of pre-pandemic perceived social support with psychological resilience and negative mental health symptoms during the COVID-19 pandemic among people with a history of injection drug use.

Methods: Between June and September 2020, we conducted a telephone survey among 545 participants in the AIDS Linked to the IntraVenous Experience (ALIVE) study: a community-based cohort of adults with a history of injection drug use. Leveraging data from study visits in 2018-early 2020, associations of pre-pandemic perceived social support with psychological resilience scores (range=1-5) and the probability of negative mental health symptoms during the pandemic were assessed using multivariable linear and modified Poisson regression models, respectively.

Results: Participants' median age was 58 years, 38.2% were female, 83.3% identified as Black, and 30.3% were living with HIV. During the pandemic, 14.5% had low (<3) resilience scores, 36.1% experienced anxiety, and 35.8% reported increased loneliness. Compared to participants in the lowest tertile of pre-pandemic social support, participants in the highest tertile had higher mean resilience scores (β = 0.27 [95% CI = 0.12, 0.43]), a lower probability of anxiety (prevalence ratio [PR] = 0.71 [95% CI = 0.52, 0.96]), and a lower probability of increased loneliness (PR = 0.62 [95% CI = 0.45, 0.84]).

Conclusions: Pre-pandemic perceived social support was associated with greater psychological resilience and generally better mental well-being during the pandemic. Interventions that improve social support may foster psychological resilience and protect the mental well-being of people who use drugs, especially during periods of social disruption.

Keywords: Anxiety; Mental health; People who inject drugs; People who use drugs; Resilience; Social support.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
COVID-19*
Depression / psychology
Female
Humans
Male
Mental Health
Middle Aged
Pandemics
Resilience, Psychological*
Social Support

Abstract

Publication types

MeSH terms

Grants and funding