Social Support and Viral Reactivation in US and Foreign-Born Mexican Americans
Rubinstein, Rebecca Judith
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Social support may explain a part of the Hispanic Paradox, the persistent pattern of mortality outcomes for low-SES Hispanic Americans that more closely compare to higher-SES Caucasians than lower-SES African Americans. Curiously, Hispanics, especially those born outside the United States, have higher levels of infection and reactivation of herpesviruses that are carcinogenic or associated with cancer, and cancer is one outcome in which Hispanics do not appear to be at an advantage. To more closely understand the relationship between social support, herpesvirus reactivation, race, ethnicity and place-of-birth, a secondary analysis of cross-sectional data from the Texas City Stress and Health Study was conducted. A maximum of 2,708 Non-Hispanic White (NHW), Non-Hispanic Black (NHB), US-Born and Foreign-Born Mexican Americans (MA) interviewed between 2004 and 2006 were studied. Perceived social support among NHW, NHB, US-Born MA and Foreign-Born MA was compared. Logistic regressions controlling for sociodemographic, health status and health behavior variables were conducted to test the association between low social support and race/ethnicity, the focal independent variables, and reactivation on two or more antigens against Epstein Barr Virus (EBV), cytomegalovirus (CMV) and herpes simplex virus-1 (HSV-1), the dependent variable. Interactions between race/ethnicity and low social support were assessed, as well as the potential confounding effect of acculturation within Mexican Americans. Results indicate that NHB reported significantly lower social support than both NHW and MA, while NHW reported lower social support than US-Born MA but not Foreign-Born MA. Low social support, Black race, and female gender were significantly associated with reactivation, while no interaction effect was identified between race/ethnicity and low social support. In analysis restricted to Mexican Americans, low social support and female gender were again associated with reactivation, and a significant and large interaction effect between nativity (country-of-birth) and low social support was identified. Subgroup analyses confirmed that low social support was strongly associated with reactivation in US-Born MA but not Foreign-Born MA. Controlling for acculturation removed the association between low social support and reactivation and the interaction between nativity and social support. The results suggest that nativity, acculturation and race/ethnicity are relevant factors to consider when assessing the relationship between social support and herpesvirus reactivation. Acculturation may mediate the relationship between social support and herpesvirus reactivation in Hispanics, and further study is needed to elucidate this relationship. Our study contributes to the role of perceived social support in the Hispanic Paradox and an understanding of the buffering hypothesis of social support among distinct cultures.