Social Support and Frailty in HIV Positive and Negative Men Who Have Sex With Men

Abstract Social support is linked to a myriad of positive health outcomes, yet little is understood about its potential role on frailty development among older men who have sex with men (MSM). We evaluated data from 929 MSM aged 40-81 years enrolled in the MACS Health Aging sub-study. Social support (Social Provisions Scale[SPS-24]; range 24-96) was high, though slightly lower among the HIV-positive versus HIV-negative men (median: 80 vs. 82, p=0.12). Each SD increase in social support associated with a 21% decrease in incident frailty (Fried phenotype), independent of age, race, and education (aIRR=0.79, IQR[0.65, 0.97]), though attenuated after adjustment for depressive symptoms. This protective association was observed to be strongest among HIV-positive MSM. High social support is a strength among older MSM, which associates with positive frailty outcomes. Assessing and strengthening social support systems may have potential as a psychosocial component of frailty interventions.

Psychological sense of community (PSOC) in Black men who have sex with men (BMSM) may facilitate condom and pre-exposure prophylaxis (PrEP) use to prevent HIV transmission. Understanding BMSM's PSOC contribution to HIV risk reduction may inform HIV prevention efforts for this population, that is disproportionately affected by HIV. Adjusted for sociodemographic characteristics and HIV status, we conducted logistic regressions to test the association between PSOC and condom use among aging BMSM (n=176). Multivariate analyses exhibited no association between PSOC and condom use (AOR= 0.994, 95% CI= 0.942, 1.049). HIV+ participants had higher condom use odds compared to HIV-participants (AOR= 4.031, 95% CI= 1. 723, 9.426). A sub-analysis of HIV-participants (n=61), showed no associated between PSOC and PrEP use (AOR= 1.002, 95% CI= 0.904, 1.112). These results have implications for secondary HIV prevention and future research on alternative aspects of social support that may increase BMSM's HIV risk reduction behaviors.
Pennsylvania, United States, 3. University of Pennsylvania,Philadelphia,Pennsylvania,United States,4. Georgetown University Medical Center,Washington,District of Columbia,United States,5. Johns Hopkins University,Baltimore,Maryland,United States Social support is linked to a myriad of positive health outcomes, yet little is understood about its potential role on frailty development among older men who have sex with men (MSM). We evaluated data from 929 MSM aged 40-81 years enrolled in the MACS Health Aging sub-study. Social support (Social Provisions Scale ; range 24-96) was high, though slightly lower among the HIV-positive versus HIVnegative men (median: 80 vs. 82, p=0.12). Each SD increase in social support associated with a 21% decrease in incident frailty (Fried phenotype), independent of age, race, and education (aIRR=0.79, IQR[0.65, 0.97]), though attenuated after adjustment for depressive symptoms. This protective association was observed to be strongest among HIV-positive MSM. High social support is a strength among older MSM, which associates with positive frailty outcomes. Assessing and strengthening social support systems may have potential as a psychosocial component of frailty interventions.

WHY AGE AND AGING RESEARCH MATTERS: A CHAT WITH NIA SENIOR LEADERSHIP Chair: Marie Bernard
The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, is the federally designated lead agency on aging research, and has supported significant research on aging as a life-long process. In the last five years, NIA experienced a tripling of its budget. Although much of this funding is targeted to Alzheimer's disease (AD) and AD related dementias (ADRD) research, there was an increase in funds allocated to non-AD research in keeping with the overall growth of NIH. This symposium will provide a forum for exploration of the implications of the budget increases for the general research community. It will involve NIA's senior staff discussing research priorities and programs supported by the Institute. A question-and-answer session will follow brief introductory remarks on current funding and future priorities and research directions of NIA.

DIVISION OF EXTRAMURAL ACTIVITIES Kenneth Santora, National Institute on Aging, Bethesda, Maryland, United States
Dr. Santora will discuss research priorities for the Division of Extramural Activities. He and his team will in addition be available for small group discussions

UPDATE ON NIH INCLUSION ACROSS THE LIFESPAN Marie Bernard, National Institutes of Health, Bethesda, Maryland, United States
The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, is the federally designated lead agency on aging research, and has supported significant research on aging as a life-long process. In the last five years, NIA experienced a tripling of its budget. Although much of this funding is targeted to Alzheimer's disease (AD) and AD related dementias (ADRD) research, there was an increase in funds allocated to non-AD research in keeping with the overall growth of NIH. This symposium will provide a forum for exploration of the implications of the budget increases for the general research community. It will involve NIA's senior staff discussing research priorities and programs supported by the Institute. A question-and-answer session will follow brief introductory remarks on current funding and future priorities and research directions of NIA. Traditionally, gerontology research has been relatively genderless. When the intersection of age and gender was explored, this was done primarily by focusing on the experiences of older women. Much less is known about the experiences of older men. The present symposium brings together work from the humanities and the social sciences in order to explore societal images and personal experiences of aging men. The paper by Maierhofer and Ratzenböck provides a theoretical outlook on this intersection from the humanities perspective, followed by empirical applications from the social sciences. Next, Armengol uses contemporary American literature to challenge the traditional stereotype of decline in sexuality and masculinity. The paper by Ni Leime & O'Neill examines stereotypes of aging masculinities, but this time from the perspective of older men as the audience who react to their portrayal in visual culture. Finally, Ayalon and Gweyrtz-Meydan present ethical dilemmas faced by physicians who treat older men's sexuality in light of active marketing campaigns of the pharmaceutical industry, which advocate for a model of successful aging and ongoing sexual intercourse. The discussant, Kimmel, will conceptualize the four papers by stressing the different types of information that can be obtained via different methods of inquiry. The complementary information provided by the different papers and the integration of methods and findings from the humanities with the social sciences will be discussed.

PHYSICIANS' MORAL DILEMMAS IN THE AGE OF VIAGRA
Liat Ayalon, Bar-Ilan University, Ramay Gan, HaMerkaz, Israel Oral phosphodiesterase5 inhibitors (PDE5i; e.g., Viagra®) have become the first line of treatment of erectile dysfunction in men. Relying on interviews with 38 physicians, this study explored moral dilemmas associated with the prescription of PDE5i to older men. Moral dilemmas at the micro