Family functioning, social vulnerability, depression and frailty among older people with HIV: A structural equation modeling analysis

AIM: This study explored the influence of family functioning on frailty among older people with HIV (PWH) and the mediating roles of social vulnerability and depression. DESIGN: A quantitative cross-sectional study. METHODS: A cross-sectional survey of older PWH from December 2022 to October 2023 was carried out in Shanghai, China. Data on sociodemographics, family functioning, social vulnerability (social isolation and loneliness), depression and multidimensional frailty were gathered and analyzed by structural equation modeling (SEM). Analysis was performed via SPSS 24.0 and AMOS 23.0. RESULTS: Family functioning affects older PWH's frailty through three indirect paths: through the mediating role of social vulnerability and depression separately and through the chain-mediating role of both social vulnerability and depression. CONCLUSIONS: Family functioning in older PWH is associated with multidimensional frailty, which is mediated by social vulnerability and depression. Based on these findings, targeted interventions focusing on improving family functioning, reducing social vulnerability, and alleviating depression may effectively prevent and mitigate frailty, thereby promoting health and wellbeing among older PWH.