data for this study came from a cohort of persons > 18 years of age who were living in the new york city metropolitan area on september 11 , 2001 . the cohort was recruited through a random digit dial telephone survey from march 25 through june 25 , 2002 . contact information was obtained and follow - up interviews were conducted from september 25 , 2002 , through january 31 , 2003 , and from september 24 , 2003 , through february 29 , 2004 . data regarding knowledge of , worry about , and attitudes toward aids and sars were collected among a randomly selected subset of participants in the second cohort follow - up . the total sample included in this analysis , for whom data about aids , sars , and social support were incomplete , consisted of 914 persons ; response rate for eligible participants was 56% . the institutional review board of the new york academy of medicine reviewed and approved this study . we collected information about respondent sex , race / ethnicity , age , educational attainment , marital status , and household income at baseline . social support was assessed by using a 5-item modified version of the medical outcomes study social support scale ( 6 ) ; this abbreviated scale has a cronbach  of 0.90 ( 7 ) . social support was categorized as low , medium , or high , on the basis of tertiles of support reported in the sample . we assessed respondents knowledge of , worry about , and attitudes toward aids and sars ( table 1 ) . we described sociodemographic characteristics and level of social support of the respondents and created multivariable models predicting knowledge of , worry about , and stigmatizing attitudes toward aids and sars , including covariates thought to potentially confound the relationship between social support and each outcome . analyses were weighted to correct potential selection bias related to the number of household telephones , persons in the household , and oversampling , as well as to make the sample demographically similar to the new york city metropolitan area population according to us census 2000 estimates . we used sudaan software to estimate standard errors and adjust analyses for the weighting ( 8) . of the 914 participants , 45.4% were male , 54.1% white , 7.6% asian or other race , 18.5% black , and 19.8% hispanic ( table 2 ) . in multivariable models controlling for sociodemographic variables ( appendix table ) , persons with low or medium levels of social support were significantly more likely than those with high levels of social support to report being poorly informed about aids ( p = 0.004 for low support , p = 0.038 for medium support ) , being very worried about aids ( p = 0.010 for medium support ) and sars ( p = 0.010 for medium support ) , and to express more stigmatizing attitudes toward sars ( p = 0.020 for low support ) . reporting higher levels of social support was independently associated with greater knowledge of aids but not of sars . lower levels of social support were associated with more stigmatizing attitudes toward sars but not aids . these patterns may be explained by differences in the epidemiology of aids and sars in new york city . aids has been associated with tremendous illness and mortality rates in new york city ( 9,10 ) . in contrast , the sars epidemic was declared globally contained by the time of data collection ( 11 ) . the psychological pathways through which social support influences responses to eids may be dependent on the effect of the epidemic on the local population . for example , greater social support may be associated with greater knowledge of aids because , relative to sars , aids is more prevalent and persons with greater social support , through their social relationships , may have greater access to information that influences development of knowledge about eids . social support was inversely associated with worry about both aids and sars , which suggested that association between social support and aids and sars my persist despite differences in the epidemiology of eids . these findings are consistent with studies showing that social interactions are associated with perceptions of the risk for hiv / aids ( 3,12 ) . several biological and psychological mechanisms have been theorized to mediate the relationship between social support and health ( 4 ) . self - efficacy , defined as the degree of confidence persons have in their ability to perform specific tasks , is hypothesized to be one of the primary pathways through which social support operates ( 4 ) . therefore , social support may act as a buffer against worry about eids . first , covariates were treated as time - fixed , which may have resulted in residual confounding . second , social support is a multidimensional construct ; specific dimensions may differentially influence knowledge of , worry about , and stigmatizing attitudes toward eids . finally , for a cross - sectional analysis , it is difficult to establish temporality between levels of social support and knowledge of , worry about , and attitudes toward aids and sars . observed associations between social support and responses to eids may be explained by a common unmeasured covariate . emerging and reemerging infectious diseases the ability to effectively mitigate disease consequences will depend , in part , on minimizing negative public responses . further research investigating the pathways linking social support to responses to eids may inform interventions that help guide public health and official responses to these diseases . variables used in multivariable models to assess the relationship between social support and knowledge , worry , and stigmatization of aids and sars in 914 study participants , new york , new york , metropolitan area *
negative public reactions to emerging infectious diseases can adversely affect population health . 
 we assessed whether social support was associated with knowledge of , worry about , and attitudes towards aids and severe acute respiratory syndrome . 
 our findings suggest that social support may be central to our understanding of public responses to emerging infectious diseases .