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. Author manuscript; available in PMC: 2015 Jan 1.
Published in final edited form as: J Gay Lesbian Soc Serv. 2014 Aug 8;26(3):279–302. doi: 10.1080/10538720.2014.924458

Associations between social support network characteristics and receipt of emotional and material support among a sample of male sexual minority youth

Farzana Kapadia 1,2, Perry Halkitis 3,4, Staci Barton 5, Daniel Siconolfi 6, Rafael Perez Figueroa 7
PMCID: PMC4157518  NIHMSID: NIHMS600176  PMID: 25214756

Abstract

Few studies have examined how social support network characteristics are related to perceived receipt of social support among male sexual minority youth. Using egocentric network data collected from a study of male sexual minority youth (n=592), multivariable logistic regression analyses examined distinct associations between individual and social network characteristics with receipt of (1) emotional and (2) material support. In multivariable models, frequent communication and having friends in one’s network yielded a two-fold increase in the likelihood of receiving emotional support whereas frequent communication was associated with an almost three-fold higher likelihood of perceived material support. Finally, greater internalized homophobia and personal experiences of gay-related stigma were inversely associated with perceived receipt of emotional and material support, respectively. Understanding the evolving social context and social interactions of this new generation of male sexual minority youth is warranted in order to understand the broader, contextual factors associated with their overall health and well-being.

Keywords: social support, social networks, youth/adolescents, sexual minority

For male sexual minority youth, the period between late adolescence and young adulthood is a time during which these youth are likely to be negotiating their sexual identities (Ott et al., 2011) in peer groups and family environments often characterized by stigma, discrimination (Huebner et al., 2004; Kann et al., 2011; Ryan et al., 2009) toward gay, bisexual and lesbian youth and potential rejection from said peers and family members. The confluence of such factors have been linked to a number of behavioral and health-related outcomes such as greater alcohol and drug use (Clatts et al., 2003; Mutchler et al., 2011; Talley et al., 2010; Wong et al., 2010), multiple sexual partnerships (Bauermeister et al., 2011; Halkitis et al., 2011), unprotected sexual activity ( Pollock & Halkitis, 2009; Wilson et al., 2009), sexual activity while high or intoxicated ( Newcomb et al., 2011; Rusch et al., 2004; Stueve et al., 2002), heightened levels of depression and depressive symptoms (Mustanski et al., 2010; Salomon et al., 2009), suicidality and suicide ideation ( Mustanski et al., 2010; O'Donnell et al., 2011; Remafedi, 2002), experiences with sexual and interpersonal violence and victimization (Kann et al., 2011; Wong et al., 2010) and heightened risk for HIV and other sexually transmitted infections (Kipke et al., 2007; Mark et al., 2005) among male sexual minority youth. Moreover, the onset of such risk behaviors as well as related physical and mental health conditions during the period of adolescence and young adulthood among sexual minority youth has a significant impact on the presence and persistence of these behaviors and health states into adulthood.

It is well documented that social processes and social behavior have a profound impact on the health and well-being of adolescents. As such, there is a large body of literature indicating that among adolescents the presence of supportive interpersonal relationships with peers and family members is related to individual-level engagement in healthy behaviors and positive health outcomes. Often, these studies employ a social network approach, grounded in social network theory, which focuses on the relationships or ties between individuals within a social system (Wasserman & Faust, 1994). Finally, the study of social networks employs either an egocentric or sociometric approach to understanding ties between individuals. An egocentric approach relies on obtaining information from an individual on their direct personal ties as well as characterization of those ties. The sociometric, or complete network, approach involves identifying all ties or relationships among and between multiple individuals (Wasserman & Faust, 1994).

Furthermore, this social network perspective postulates that information or resources are transmitted across ties amongst individuals within a network via social processes or interactions. Therefore, the ability of social networks to influence individual-level, health-related behavior is measured by the structure (e.g. the size, relationship with and characteristics of network members) of an individual’s social network ties and the type and quality of content shared between network members. Most frequently, the type of content transmitted across social ties, or shared between network members, includes normative attitudes, behavioral information, and support in the form of information and material resources that may ultimately influence the health-related attitudes and behaviors of an individual.

Despite theoretical frameworks that provide distinct mechanisms of action linking social networks and social processes and a pro-analytic tech, most empirical investigations examining the influence of these factors on health behavior and health conditions have examined them as disjointed factors. This dichotomy in investigating the role of social networks and social processes is reflected in the extant empirical evidence linking these factors to health outcomes among sexual minority youth. For example, a number of studies have examined variations in the structural characteristics of social and sexual networks such as size, composition, density, and partner concurrency with regard to HIV/STI transmission dynamics (Kapadia et al., 2013; Latkin et al., 2010a). In addition, more recent research has considered factors such as social embeddedness, isolation and social status with regard to outcomes ranging from depression, and anxiety to suicide and suicidal ideation among sexual minority youth (Hatzenbuehler et al., 2012). With regard to social processes, the bulk of research has been directed at understanding the role of normative influences, in terms of injunctive as well as descriptive norms within peer networks, for their potential to influence HIV-related sexual and drug use behaviors (Davey-Rothwell et al., 2012; Jones et al., 2008; Latkin et al., 2010b; Tyler & Melander, 2012).

Finally, beyond normative influences, social processes such as differential receipt of social support from social network members play a salient role in the production of health related disparities among sexual minority youth. In fact, the absence of social support is considered a fundamental cause of illness and disease (Link & Phelan, 1995; Phelan et al., 2010). Thus, the presence and receipt of social support is postulated to be a protective factor against stressors associated with psychological or physiological outcomes (Thoits, 1995). This, buffering effect, may be particularly salient to the lives of sexual minority youth, for whom there is compelling evidence indicating that experiences of internalized homophobia (Brooks et al., 2005; Choi et al., 2011; Kubicek et al., 2009; Stokes & Peterson, 1998), prejudice, stigma and discrimination based on sexual orientation, and extent of ethnic versus gay community affiliation (Gold et al., 1994; Holt, 2011), act as stressors (Meyer, 2003) and in turn, play a salient role in the production of health related disparities among sexual minority youth compared to their heterosexual counterparts.

In summary, although different approaches to assessing the influence of social interaction and social networks among sexual minority youth have been utilized, these findings nonetheless provide strong evidence for health promotion and intervention efforts on the network level as a crucial component to improving the health and overall well-being of sexual minority youth (Amirkhanian et al., 2005; Egan et al., 2011; Fuqua et al., 2011; Kelly et al., 2010; Latkin & Knowlton, 2005; Peterson et al., 2009; Tobin & Latkin, 2008). Thus, in order to tap into the potential of social support as a protective factor among sexual minority youth, investigation of social support network characteristics as they relate to receipt of social support is warranted. More specifically, exploring key factors characterizing social support networks and their relationship to the types of perceived support provided by these network members of sexual minority youth, may help researchers identify the social structures or ties that are most likely to facilitate or impede provision of network-level supportive influences. Within this context, the objective of the present study was to examine key social support network characteristics for their relationship with perceived receipt of emotional and material support after controlling for individual level sociodemographic and psychosocial factors among a new generation of sexual minority youth.

Method

Study Design and Sample

For the present analysis, we employed baseline data from a prospective cohort study of male sexual minority youth who are diverse with regard to socioeconomic status as well as race/ethnicity. The full details of the parent study are already published (Halkitis et al., 2013b; Halkitis et al., 2013a). Briefly, participants were recruited in New York City via a combination of active and passive modalities ranging from recruiting potential participants at community events, bars/club, etc. to website advertisement or social networking sites, etc. Eligible participants had to be born biologically male; between 18 and 19 years old; self-report having had sex with a man in 6 months preceding the screening interview; and also self-report an HIV-negative or unknown serostatus. After providing written, informed consent, participants completed an audio-computer administered survey instrument (ACASI) to provide data on individual-level sociodemographic characteristics and a comprehensive range of psychosocial factors. A social support network inventory was used to ascertain information on up to 10 network members whom study participants considered to be ‘significant or important’ in their lives as well information on receipt of emotional support and material support from these members (Norbeck et al., 1981).

Among the 2,068 individuals screened for this study, n=598 completed the baseline assessment. In this baseline sample, n=6 were identified as HIV-seropositive and therefore excluded from the present analysis as receipt of social and emotional support is likely to be associated with HIV status and the limited sample size restrictions prevent further analyses. Thus, the final sample size for the present study is n=592. This study protocol was approved by New York University’s Institutional Review Board (IRB), and a Certificate of Confidentiality was obtained from the Department of Health and Human Services. All participants were remunerated for their time and effort in accordance with local community guidelines.

Dependent Variables

Perceived social support was examined in terms of two distinct domains salient to the lives of male sexual minority youth: perceived receipt of emotional support and material support. A 6-item measure comprised of two sub-scales was used to ascertain information on the perception of types of support received; responses to these items were rated on a 5-point scale ranging from ‘not at all’ to ‘a great deal’ with higher scores indicating higher levels of perceived support. The emotional support sub-scale consisted of 4-items such as ‘How much does this person make you feel liked or loved?’ The material aid sub-scale consisted of 2-items such as ‘If you were confined to bed for several weeks, how much could this person help you?’ These subscales also have high internal validity (Cronbach α = 0.97 and 0.91 for emotional support and material support, respectively). For the present analysis perceived receipt of emotional and material support were dichotomized as high versus low. This dichotomization is based on prior research indicating that higher levels of perceived support are more likely to be associated with actual support rather than when perceived support increases incrementally.

Independent Variables

Sociodemographic Characteristics

A number of sociodemographic characteristics were examined. Participants’ self-reported racial/ethnic identity was examined as: Latino/Hispanic, Black/non-Hispanic, White/non-Hispanic, and Asian/mixed race/other. Educational status was assessed via a single item ascertaining whether participants were currently enrolled in school (yes/no). Socio-economic status (SES) was ascertained by asking participants about their perceived social class since at their age of enrollment they were unlikely have their own yearly income and also less likely to accurately recall their family income. Perceived SES was categorized as lower, middle and upper class. Foreign-born status was determined by ascertaining whether participant had been born in the US versus outside the US. Current housing was dichotomized as stably housed (i.e. reside in one’s own/family home) versus unstably housed/homeless (i.e. reside in a shelter, public space, etc.) (Aidala et al., 2005). In addition, residential instability was analyzed by considering the number of times participants reported moving since birth. Participants reporting more than 2 moves were classified as having a higher degree of residential instability versus those with ≤2 moves. We examine residential mobility as participants who experience greater mobility prior to ages 18–19 may also be likely to experience changes in their network characteristics, which in turn may impact perceived receipt of social support. The dichotomization of housing status and residential stability variables was conducted to allow for comparisons across studies of sexual minority youth. Sexual identity was measured using the Kinsey scale which ranges from 0 to 6 (exclusively heterosexual to exclusively homosexual). For the present study, sexual identity was dichotomized as ‘exclusively homosexual’ versus ‘not exclusively homosexual’ in order to be able to determine whether there were any empirical differences in perceived receipt of social support among participants who fully identified with a homosexual identity or same sex preference versus participants whose sexual identities were still in development. Finally, participants were also asked whether or not they were currently in a relationship with a man (yes/no).

Health Status and Psychosocial Factors

Overall health status was assessed using a one-item self-rated health measure. The item, “In general, would you say that your health was…?” was measured on a five point scale with responses ranging from excellent to poor. The role of psychosocial factors in relationship to physical and mental health outcomes has been widely researched. However, little attention has been given to the role of both psychosocial factors in relation to receipt of social and material support among sexual minority youth. As such, we examined a number of factors salient to the lives of sexual minority youth for their relationship to the receipt of emotional and social support. First, participants were asked to report on their ethnic identity affinity using the 12-item Multigroup Ethnic Identity Measure (e.g. ‘I have a lot of pride in my ethnic group’, etc.); responses ranged from “strongly agree” to “strongly disagree” and for the purposes of this analysis were dichotomized as low (≤2) versus high (>2) (Phinney, 1992). Second, gay community affiliation was assessed using a 1-item measure: ‘I feel a part of the gay community in New York City’; responses ranged from “strongly agree” to “strongly disagree” and were dichotomized as high (≤2) versus medium/low (≥3) (O’Donnell et al., 2002). Third, two types of gay related stigma were also assessed in this study: personalized and public gay related stigma (Frost et al., 2007). Personalized gay related stigma was measured via a 3-item measure (e.g. ‘I have been hurt by how people reacted to learning I’m gay’, etc.) with responses ranging from ‘strongly agree’ to ‘strongly disagree.’ Experience of gay related stigma in public venues was measured via a 2-item measure (e.g. ‘Most people think a person who is gay is disgusting’, etc.) with responses also ranging from ‘strongly agree’ to ‘strongly disagree.’ Both measures of personalized and public gay-related stigma were dichotomized as high versus low. Fourth, feelings of internalized homophobia (e.g. ‘Sometimes I dislike myself for being gay/bisexual’, etc.) were measured on a 4-item scale with responses ranging from ‘strongly disagree’ to ‘strongly agree’; internalized homophobia was dichotomized as high versus low for the present analysis (Thiede et al., 2003). Finally, we asked participants to report on whether their peers knew of their same sex behaviors. This measure was not included in the social support network inventory as our goal was to understand, writ large, whether these participants had come out to a larger and broader group of acquaintances who may or may not have been close friends. The categorical covariates described here were dichotomized for the present analysis by employing theoretically meaningful cut points that also facilitate interpretation of the results obtained.

Social Support Network Characteristics

To identify the characteristics of participants social support networks, participants were first asked to identify “…persons who provide personal support for you or who are important to you now.” Once network members were enumerated, participants were asked to identify their relationship to each one of these nominated network member (e.g. family/relative, friends, etc.). It is important to note that participants used a broader definition of family member than that employed in traditional network analyses by including family members of choice in addition to biological family members. This decision is rooted in the rejection by biologic family members that many YMSM, particularly Black and Latino/Hispanic YMSM may experience upon coming out (Serovich et al., 2011). Initial exploration of the distribution of reported network members yielded a non-normal distribution for network size with the distribution skewed to the right (mean= 7.76, SE=0.10; median= 8, SD=2.3, IQR=6–10). As such, network size was dichotomized as <8 versus ≥8. Next, participants provided information on the duration of each relationship by responding to the question “How long have you known this person” (responses ranged from <6 months to >5 years). For the present study, average duration of network relationships was dichotomized as < 2 years versus ≥2 years. This dichotomization has both empirical and conceptual merit. First, 2 years was the also the median length of reported relationships. Second, this cut-point allows an examination of differences in receipt of emotional and material support in recently formed networks versus those of longer duration. Finally, participants were asked to report on communication frequency with each network member on a 5-point scale ranging from ‘daily’ to ‘once a year or less.’ Communication frequency was dichotomized as ≤monthly versus ≥weekly. This dichotomization was also supported by empirical evidence as, on average, participants reported communicating with network members on a weekly basis in the present sample. Conceptually, more frequent communication is also associated with stronger network ties than less frequent communication.

Statistical Analysis

Initially, univariable analyses were completed to describe the extent of emotional and material support in this sample of male sexual minority youth. Next, separate bivariable analyses were undertaken to examine sociodemographic characteristics and psychosocial factors associated with emotional support and material support. In addition, social network structural characteristics such as size, composition, duration and frequency of contact were also examined for their associations with emotional and material support, respectively. Statistical significance was evaluated using chi-square and Fishers exact statistics, as appropriate, for all bivariable associations assessed here. Based on findings from bivariable associations well as a priori hypotheses, separate multivariable logistic regression models, for emotional and material support, were built to identify distinct sets of factors independently associated with each of the support measures under study here. In this way, models for each outcome, emotional and material support, were built by first including one distinct social support network characteristic. Next, we added sociodemographic and then psychosocial characteristics found to have a statistically significant association (p<0.05), or based on a priori knowledge, with emotional and material support, respectively, in conceptually related group. Model building was guided by comparing the −2 log likelihood value to obtain the final models of best fit for emotional and material support.

Results

In this sample of young, emerging adult men, we found that 17% reported low levels of perceived emotional support whereas 28% reported lack of perceived material support from their nominated social support network members. In bivariable analysis, (Table 1) YMSM who reported lower perceived SES (44% vs. 31%, p=0.037) and a not an ‘exclusively homosexual’ sexual identity (68% vs. 57%, p=0.023) were more likely to report low levels of perceived social support. In addition, YMSM who reported higher levels of personalized gay-related stigma (58% vs. 47%, p=0.024) and internalized homophobia (38% vs. 24%, p=0.004) were more likely to low levels of perceived emotional support. With regard to perceived receipt of material support, YMSM who reported lower perceived SES (45% vs. 29%, p=0.001), non-exclusively homosexual identity (64% vs. 56%, p=0.045), and higher levels of personalized gay-related stigma (58% vs. 45%, p=0.002) were also more likely to report low levels of perceived material support.

Table 1.

Sociodemographic characteristics and perceived receipt of emotional and material support among sexual minority youth, NYC, 2009–2011, n=592

Emotional Support Material Support
Total High (n=490) Low (n=100) p-value High (n=428) Low (n=163) p-value
% (n) % (n) %(n) % (n) %(n)
Race/ethnicity
   Black/African American 16.3 (96) 16.1 (79) 17.7 (17) 0.799 15.7 (67) 17.8 (29) 0.934
   Hispanic/Latino 38.0 (224) 38.6 (189) 35.0 (35) 38.6 (165) 36.8 (60)
   White 30.3 (179) 29.6 (145) 34.0 (34) 30.4 (130) 30.1 (49)
   Asian/mixed/other 15.4 (91) 15.7 (77) 14.0 (14) 15.4 (66) 15.3 (25)
Current level of in schooling
   JHS/HS 19.7 (100) 18.6 (79) 25.0 (21) 0.118 18.4 (69) 23.0 (31) 0.157
   College/Univ 80.3 (408) 81.4 (345) 75.0 (63) 81.6 (305) 77.0 (104)
Perceived SES
   Lower 33.2 (196) 31.0 (152) 44.0 (44) 0.037 29.0 (124) 44.8 (73) 0.001
   Middle 36.9 (218) 37.8 (185) 33.0 (33) 39.3 (168) 30.7 (50)
   Upper 29.8 (176) 31.2 (153) 23.0 (23) 31.8 (136) 24.5 (40)
Foreign born (yes) 11.0 (65) 10.4 (51) 14.0 (14) 0.190 10.3 (44) 12.9 (21) 0.222
Residential Instability
   High 56.6 (334) 55.5 (272) 62.0 (62) 0.139 56.5 (242) 56.4 (92) 0.528
   Low 43.4 (256) 44.5 (218) 38.0 (38) 43.5 (186) 43.6 (71)
Current Housing
   Stably housed 94.9 (555) 95.1 (462) 93.9 (93) 0.398 94.8 (402) 95.1 (154) 0.546
   Unstably housed 5.1 (30) 4.9 (24) 6.1 (6) 5.2 (22) 4.9 (8)
Sexual identitya
   Exclusively homosexual 41.4 (244) 43.3 (212) 32.0 (32) 0.023 43.7 (187) 35.6 (58) 0.045
   Not exclusively homosexual 58.6 (346) 56.7 (278) 68.0 (68) 56.3 (241) 64.4 (105)
Relationship status
   In male-male relationship 26.6 (157) 27.8 (136) 21.0 (21) 0.101 27.1 (116) 25.2 (41) 0.356
   Not in a relationship 73.4 (433) 72.2 (354) 79.0 (79) 72.9 (312) 74.8 (122)
Ethnic Identity/Affinity (high) 38.1 (225) 39.2 (192) 33.0 (33) 0.147 38.6 (165) 36.8 (60) 0.385
Gay community affiliation (high) 42.0 (248) 43.5 (213) 35.0 (35) 0.072 42.1 (180) 42.3 (69) 0.512
Gay related stigma –personalized (high) 48.5 (286) 46.5 (228) 58.0 (58) 0.024 44.6 (191) 58.3 (95) 0.002
Gay related stigma –public (high) 47.6 (281) 46.7 (229) 52.0 (52) 0.197 45.8 (196) 52.1 (85) 0.099
Internalized homophobia (high) 26.4 (156) 24.1 (118) 38.0 (38) 0.004 25.5 (109) 28.8 (47) 0.233
Peer knowledge of same sex behavior
   Some/few don’t know 69.0 (407) 70.0 (343) 64.0 (64) 0.144 70.6 (302) 65.0 (106) 0.115
   Most/all know 31.0 (183) 30.0 (147) 36.0 (36) 29.4 (126) 35.0 (57)
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Next, upon examining social support network characteristics and their relationship to perceptions of emotional and material support, YMSM who reported friends as members of their social support networks were more likely to report higher levels of perceived emotional support (95% vs. 89%) compared to those not reporting friends as part of these networks (p=0.041). Further, individuals with family members in their social support networks were less likely to report perceived emotional support, although this relationship was marginally significant (p=0.090). YMSM who reported more frequent communication with their social support network members (≥weekly communication) were more likely to report perceived emotional support (84% vs. 71%, p=0.002). Finally, those with longer duration of relationships, on average, with their social support network members were more likely to report lower levels of perceived emotional support, although this relationship did not reach statistical significance (p=0.082). In terms of perceived receipt of material support, those reporting family members in their social support networks (96% vs. 92%, p=0.042) and having more frequent communication with their social support network members, across relationship type (87% vs. 70%) as well as, on average, longer duration of relationship with their social support network members (69% vs. 61%, p=0.044)were more likely to report higher levels of material support.

In multivariable analyses controlling for sociodemographic characteristics and psychosocial factors, YMSM reporting friends as part of their social support networks were more than two times more likely to report higher levels of perceived emotional support (AOR = 2.31, 95% CI 1.05, 5.02) (Table 3). Similarly, YMSM who reported greater communication frequency with their social support network members were also more than two times more likely to report higher perceptions of emotional support (AOR = 2.18, 95% CI 1.28, 3.70). Whereas in multivariable analyses examining social support network characteristics associated with perceived receipt of material support (Table 4), YMSM who reported more frequent communication with social support network members were almost three times more likely to report higher levels of material support (AOR = 2.93, 95% CI 1.87, 4.64).

Table 3.

Multivariable logistic regression models for factors associated with perceived receipt of emotional support among sexual minority youth

Model 1 Model 2 Model 3 Model 4 Model 5
Unadjusted
OR (95% CI)		 AOR (95% CI) AOR (95% CI) AOR (95% CI) AOR (95% CI) AOR (95% CI)
Perceived SES
   Lower 0.52 (0.30, 0.90) 0.49 (0.26, 0.91) 0.47 (0.25; 0.88) 0.49 (0.27; 0.93) 0.46 (0.25; 0.86) 0.48 (0.26; 0.91)
   Middle 0.84 (0.48, 1.50) 0.69 (0.38; 1.27) 0.69 (0.37; 1.26) 0.68 (0.37; 1.26) 0.66 (0.39; 0.99) 0.70 (0.38; 1.28)
   Upper 1.00 1.00 1.00 1.00 1.00 1.00
Self-rated health
   Excellent/very good 2.66 (1.68, 4.21) 2.38 (1.47, 3.84) 2.33 (1.44, 3.78) 2.40 (1.48, 3.89) 2.37 (1.46, 3.85) 2.42 (1.49, 3.92)
   Good/fair/poor 1.00 1.00 1.00 1.00 1.00 1.00
Sexual identity
   Identify as exclusively gay 1.62 (1.03, 2.56) 1.53 (0.95, 2.50) 1.51 (0.93, 2.46) 1.52 (0.94, 2.47) 1.48 (0.91, 2.41) 1.50 (0.92, 2.44)
   Nonexclusively gay identity 1.00 1.00 1.00 1.00 1.00 1.00
Gay related stigma – personalized
   High 0.63 (0.41, 0.97) 0.61 (0.39, 0.96) 0.61 (0.38, 0.95) 0.60 (0.38, 0.95) 0.63 (0.40, 1.00) 0.59 (0.37, 0.93)
   Low 1.00 1.00 1.00 1.00 1.00 1.00
Internalized homophobia
   High 0.52 (0.33, 0.82) 0.58 (0.36, 0.95) 0.59 (0.36, 0.95) 0.57 (0.35, 0.92) 0.58 (0.36, 0.95) 0.58 (0.36, 0.93)
   Low 1.00 1.00 1.00 1.00 1.00 1.00
Network composition
   Sexual Partner 1.10 (0.65, 1.86) 0.94 (0.54, 1.64) -- -- -- --
Network composition
   Family members 0.4 (0.08, 1.43) -- 0.33 (0.08, 1.42) -- -- --
Network composition
   Friends 2.12 (1.01, 4.43) -- -- 2.31 (1.05, 5.02) -- --
Frequency of communication
   ≥weekly 2.19 (1.33, 3.59) -- -- -- 2.18 (1.28, 3.70) --
   ≤monthly 1.00 1.00
Average duration of relationships
   ≥2 years 0.69 (0.43, 1.21) -- -- -- -- 0.63 (0.38, 1.04)
   < 2 years 1.00 1.00
−2 Log Likelihood 500.064 497.139 496.061 491.851 496.269
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Adjusted models control for race/ethnicity

Table 4.

Multivariable logistic regression models for factors associated with perceived receipt of material support among sexual minority youth

Model 1 Model 2 Model 3 Model 4 Model 5
Unadjusted OR
(95% CI)		 AOR (95% CI) AOR (95% CI) AOR (95% CI) AOR (95% CI) AOR (95% CI)
Perceived SES
   Lower 0.50 (0.32, 0.79) 0.48 (0.29, 0.79) 0.49 (0.29, 0.81) 0.47 (0.28, 0.78) 0.43 (0.26, 0.73) 0.47 (0.28, 0.78)
   Middle 0.99 (0.62, 1.59) 0.90 (0.55, 1.48) 0.90 (0.55, 1.49) 0.90 (0.55, 1.48) 0.85 (0.51, 1.42) 0.89 (0.54, 1.46)
   Upper 1.00 1.00 1.00 1.00 1.00 1.00
Self-rated health
   Excellent/very good 1.73 (1.15, 2.62) 1.50 (0.98, 2.29) 1.52 (0.99, 2.33) 1.49 (0.97, 2.29) 1.49 (0.96, 2.30) 1.47 (0.96, 2.26)
   Good/fair/poor 1.00 1.00 1.00 1.00 1.00 1.00
Sexual identity
   Identify as exclusively gay 1.41 (0.97, 2.04) 1.47 (0.99, 2.18) 1.48 (1.01, 2.20) 1.47 (0.99, 2.17) 1.42 (0.95, 2.10) 1.51 (1.02, 2.24)
   Nonexclusively gay identity 1.00 1.00 1.00 1.00 1.00 1.00
Gay related stigma – personalized
   High 0.58 (0.40, 0.83) 0.55 (0.38, 0.80) 0.55 (0.38, 0.81) 0.55 (0.38, 0.80) 0.56 (0.38, 0.82) 0.57 (0.39, 0.83)
   Low 1.00 1.00 1.00 1.00 1.00 1.00
Network composition
   Sexual Partner 1.09 (0.70, 1.68) 0.98 (0.63, 1.54) -- -- -- --
Network composition
   Family members 2.10 (0.99, 4.42) -- 2.03 (0.94, 4.38) -- -- --
Network composition
   Friends 0.80 (0.37, 1.73) -- -- 0.75 (0.34, 1.66) -- --
Frequency of communication
   ≥weekly 2.80 (1.81, 4.31) -- -- -- 2.93 (1.85, 4.64) --
   ≤monthly 1.00 1.00
Average duration of relationships
   ≥2 years 1.41 (0.97, 2.06) -- -- -- -- 1.41 (0.96, 2.09)
   < 2 years 1.00 1.00
−2 Log likelihood 665.535 662.403 664.999 644.265 661.908
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Adjusted models control for race/ethnicity

Discussion

For sexual minority adolescents and young adults, health and well-being is a product of a complex constellation of risk and protective factors that may influence myriad health related behaviors and outcomes. One of the most essential of these determinants is the social context within which sexual minority youth and young adults are nested, as well as the type and quality of their relationships to peers, family members, partners and others within this context. In the present study, we sought to initiate an exploration of these factors and provide some insights into the potential role of social network characteristics as they relate to the perceived receipt of two distinct types of social support – emotional and material support. The main findings of this study suggest that sexual minority youth in this sample reported, on average, a high level of perceived social support. This finding is in contrast with prior studies that have noted lower levels of perceived social support from peers and family members of sexual minority youth compared to their heterosexual counterparts ( Crawford et al., 2002; Jamil et al., 2009; Martinez & Hosek, 2005; Pearson & Wilkinson, 2013). One possible explanation for this finding may be that perceived social support was examined across different types of social network ties (e.g. peers, family members, etc.) rather than per specific relationship types.

In terms of social support network characteristics, index participants who indicated the presence of friends in one’s social network as well as more frequent communication with network members were more likely to report increased emotional support. One potential explanation for the relationship between emotional support and the presence of friends in one’s social network may be that by late adolescence/young adulthood, sexual minority youth have identified and associate with a core group of peers whom they trust and who are, therefore, more likely to provide the types of emotional support required during this dynamic period of development. Second, this finding suggests that frequent communication via active engagement and interaction with network members is an indicator for social integration within one’s network for sexual minority youth. Consequently, fostering better integration with a core group of trusted peers through frequent communication and interaction may not only increase social support but also have the potential to mitigate feelings of isolation and symptoms associated with depression, thereby promoting positive mental and physical health outcomes among male sexual minority youth.

In addition, greater communication frequency was again associated with reports of perceived material support. However, it is also of interest to note that while reporting a family member in one’s social support network as well as longer, average duration of relationships with network members were each associated with receipt of material support in bivariable analysis, these factors were only marginally statistically significant in multivariable analyses. While prior work has noted lower level of social support from family members of sexual minority youth, these findings indicate that family members may still play an integral role in providing instrumental support or aid to sexual minority youth. It is also important to note that youth may not have reported family network members who provide no social support, or negative social support, and so the family members indicated may represent a select group of family members who provide positive support. Furthermore, it may also be that family members as defined here include both biological and non-biological family ties as sexual minority youth sustain or create ties that will support them during this critical time period.

Finally, in addition to the social support network characteristics discussed, it is of importance to note that three distinct individual level factors were associated with perceived receipt of social support in different directions. First, better self-rated health was associated with higher levels of perceived receipt of both emotional and material support in this sample of male sexual minority youth. Two explanations for this finding are offered. First, those reporting better overall health may be doing so because of a greater ability to harness both emotional and material support from their network members. Alternatively, it may be that those reporting better health states do so because of the greater emotional and material support already received from their network members. The existence of these possibilities is likely a reflection of the fact that what we are measuring is perceived receipt of social support rather than actual receipt of social support in a cross-sectional study. Second, male sexual minority youth reporting a lower perceived SES were more likely to indicate lower levels of perceived emotional and material support. One reason for this finding may be that youth from more economically disadvantaged neighborhoods may be more likely to include family/relatives as well as other youth from similar economically disadvantaged backgrounds as social support network members. Further, it has been suggested that there may be fewer opportunities for male sexual minority youth to interact and engage with network members from similarly disadvantaged backgrounds. Thus, these limited social interactions may be linked to lower levels of perceived receipt of emotional support as well. Third, greater internalized homophobia was associated with lower levels of perceived emotional support. Despite efforts geared toward fostering greater acceptance of male same sex youth (Cahill et al., 2013), the internalization of same sex stigma and experiences of discrimination are still present during the period of late adolescence. As such, youth who experience greater internalized homophobia may not fully disclose their sexual orientation to social support networks and thus less likely to obtain or solicit the requisite levels of emotional support. This finding also confirms that sexual minority youth are at a heightened vulnerability via both internal and external mechanisms that may serve to increase their likelihood for experiencing negative mental health outcomes.

Before we can draw final conclusions from these results, certain study limitations must be considered. First, as these findings are derived from cross-sectional data, temporality cannot be established and as such, it is not possible to assess the causal relationship between social support network characteristics and perceived receipt of emotional and material support within this sample of sexual minority youth. For example, it may be that social support network characteristics shape the distinct types of social support provided to sexual minority youth or that these youth seek out and maintain relationships with peers who are more likely to provide the supportive environments that are critical to health and well-being during this period of transition from adolescence to young adulthood. Second, data on social network characteristics and social support were obtained via interviewer-administered assessments whereas sociodemographic and psychosocial characteristics were ascertained via ACASI. Consequently, there may be some response bias motivated by social desirability responding. Third, these data derive from an egocentric network data collection methodology. As such, these measures of perceived receipt of emotional and material support may not be fully reflective of the actual levels of emotional and material social support provided by each nominated network member. In addition, our measures of social support are unidirectional and do not tap into provision of social support by index participants to their respective network members. Consequently, we are unable to assess the bidirectional nature of social support as it relates to fostering and sustaining ties with network members, and how this would relate to overall health and well-being. However, the broader literature on social support indicates that perceived receipt of social support is more predictive of health compared to provision of support. Nonetheless, future studies employing a complete network or sociometric approach and thereby identifying and surveying nominated network members would be able to more accurately capture actual levels of social support received from social support network members as well as levels of social support provided to their social support network members. On a related note, a complete network assessment would allow for a more accurate assessment of network homophiliy and how social support differs among networks of high versus low homophily. For example, information on the proportion of nominated network members who also identify as sexual minority youth would allow for an assessment of whether network characteristics such as relationship duration and frequency of communication as well as perceived receipt of social support differ by sexual minority status of network members. Finally, we did not assess negative social support, or relationship strain, which may also have significant implications for sexual minority youth mental health and well-being.

Despite these study limitations, key study strengths merit acknowledgement as well. First, this sample is derived from a large scale study of a socioeconomically and racially/ethnically diverse sample of sexual minority youth. Second, to our knowledge, this is the first study to initiate examination of both social network characteristics and two distinct types of social support – emotional and material support –in this vulnerable population. Finally, we examine these social determinants of health among sexual minority youth coming of age at a time characterized by important transitions in the sociopolitical and health contexts of the lived experiences of gay men in the United States. In conclusion, a more nuanced understanding of contextual factors that shape the social organization of health among sexual minority youth is warranted. Specifically, further investigation is required to provide greater insight into the social dynamics through which social networks and social support influence and sustain the health and well-being of this new generation of sexual minority youth as they enter into adulthood.

Table 2.

Social network characteristics and perceived receipt of emotional and material support among sexual minority youth, NYC, 2009–2011, n=592

Emotional Support Material Support
Total High
(n=490)		 Low
(n=100)		 p-value High
(n=428)		 Low
(n=163)		 p-value
% (n) % (n) %(n) % (n) %(n)
Network Size
   ≤8 members 51.2 (302) 51.2 (251) 51.0 (51) 0.527 51.6 (221) 50.3 (82) 0.422
   >8 members 48.8 (288) 48.8 (239) 49.0 (49) 48.4 (207) 49.7 (81)
Network composition*
   Sexual Partner 22.4 (132) 22.7 (111) 21.0 (21) 0.415 22.9 (98) 21.5 (35) 0.401
   Family members 94.9 (560) 94.3 (462) 98.0 (98) 0.090 96.0 (411) 92.0 (150) 0.042
   Friends 93.6 (552) 94.5 (463) 89.0 (89) 0.041 93.2 (399) 94.5 (154) 0.365
Frequency of communication
   ≤monthly 18.0 (106) 15.7 (77) 29.0 (29) 0.002 13.3 (57) 30.1 (49) <0.001
   ≥weekly 82.0 (483) 84.3 (412) 71.0 (71) 86.7 (370) 69.9 (114)
Average duration of relationships
   < 2 years 33.4 (197) 34.8 (170) 27.0 (27) 0.082 31.4 (134) 39.3 (64) 0.044
   ≥2 years 66.6 (392) 65.2 (319) 73.0 (73) 68.6 (293) 60.7 (99)
Open in a new tab
*

categories are not mutually exclusive

Acknowledgments

This study was funded by the National Institute on Drug Abuse, Contract #R01DA025537 awarded to Perry N. Halkitis.

Contributor Information

Farzana Kapadia, Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of, Culture, Education & Human Development, New York University, NY; Department of Population Health, Division of General Internal Medicine, Langone School, of Medicine, New York University.

Perry Halkitis, Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of, Culture, Education & Human Development, New York University, NY; Department of Population Health, Division of General Internal Medicine, Langone School, of Medicine, New York University.

Staci Barton, Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of, Culture, Education & Human Development, New York University.

Daniel Siconolfi, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public, Health, Baltimore, Maryland.

Rafael Perez Figueroa, Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of, Culture, Education & Human Development, New York University.

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