0269 Social Connectedness and Sleep Health Among People with HIV Compared to HIV-Negative Controls: Preliminary Findings from Botswana

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Abstract Introduction Sleep disturbance is common among people with HIV (PWH), even with viral suppression. Social connectedness may buffer stress-related effects on sleep, yet it is unclear whether objective (network size/diversity) and subjective (loneliness) isolation function differently for PWH and HIV-negative adults. This exploratory study examined associations between social connectedness and sleep disturbance in adults in Botswana. Methods We analyzed cross-sectional survey data from 500 PWH (mean age = 52.5; 74% female) and 300 HIV-negative adults (mean age = 53.7; 78% female). Sleep disturbance was assessed using PROMIS Sleep Disturbance. Objective and subjective social connection were measured using the Berkman–Syme Social Network Index (SNI) and the UCLA Loneliness Scale. Multivariate regressions adjusted for age, and sex, non-HIV comorbidities, and explored moderation by HIV status and age. Results PWH had significantly greater comorbidity burdens (p < .001) and higher sleep disturbance (p = .002) than HIV-negative adults, despite comparable levels of loneliness and SNI. Subjective isolation showed a consistent association with poorer sleep across groups: greater loneliness predicted higher sleep disturbance in both PWH (b = 4.44, 95% CI [3.48, 5.41]) and HIV-negative individuals (b = 3.94, 95% CI [2.90, 4.99]). Objective isolation demonstrated a group-specific pattern. Among HIV-negative adults, higher SNI, indicating more diverse social networks, was linked to lower odds of moderate-to-severe sleep disturbance (OR = 0.58, 95% CI [0.41, 0.81]). This association was weaker and non-significant among PWH (OR = 0.84, 95% CI [0.65, 1.08]). A significant HIV status × SNI × age interaction (p = .039) indicated that the protective effect of network diversity was strongest among older HIV-negative adults, while older PWH showed minimal sleep benefit from greater objective social connectedness. Conclusion Findings confirm a high burden of sleep disturbance among PWH and suggest that diverse social networks confer less sleep protection for aging PWH than for HIV-negative adults. While reducing loneliness appears beneficial across groups, interventions for older PWH may need to prioritize enhancing the quality and supportiveness of relationships rather than increasing network size. Future work will clarify the relative contributions of loneliness and network diversity to sleep disturbance, particularly among older PWH. Support (if any) Internal grant from University of Botswana

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