Collection of gender identity data in national probability-based surveys began in 2014, an important first step toward the inclusion of gender identity measurements in public health surveillance. However, the findings about health disparities from probability-based samples do not align with those from nonprobability samples traditionally used to study transgender populations. These contradictions have yet to be understood fully. In this article, we suggest that the truth about disparities lies somewhere between nonprobability and probability samples. We discuss why generalizability from studies using probability sampling may remain limited for transgender populations and describe potential improvements in sampling methodology for transgender populations.

Objective

This study examines the association between social support and cognitive function among midlife and older MSM living with or without HIV.

Design

We analyzed longitudinal data from participants enrolled from October 2016 to March 2019 in the Patterns of Healthy Aging Study, a substudy of the Multicenter AIDS Cohort Study.

Methods

We conducted a cross-sectional analysis to estimate the association between social support and three measures of cognitive function [Trail Making Test (TMT) Part A, TMT Part B to A ratio, and Symbol Digit Modalities Tasks (SDMT)]. We also used linear mixed-effects models to estimate the association between baseline social support and cognitive function across four subsequent time points. We evaluated a multiplicative interaction term between baseline social support and time, in order to determine whether cognitive trajectories over time vary by baseline social support.

Results

Social support was associated with lower TMT Part A scores at baseline and over the subsequent 2 years, indicating better psychomotor ability. Social support was associated with higher SDMT scores at baseline and across 2 years, indicating better information processing. We observed no association between social support and TMT B to A ratio at baseline or across 2 years, indicating no effect on set-shifting ability. Longitudinal cognition outcome trajectories did not vary by the level of baseline social support.

Conclusion

Social support and cognitive function were associated in this sample over a short time period. Further research should explore causal relationships over the lifespan.