Social networks and HIV treatment adherence among people with HIV initiating treatment in rural Uganda and peri-urban South Africa

Bibliographic Data

ID15742316
AuthorsAlison B Comfort (0000-0001-6713-5258, University of California, San Francisco, corresponding author), Stephen Asiimwe (0000-0001-6440-0036, Mbarara University of Science and Technology), Gideon Amaniyre (Makerere University), Catherine Orrell (0000-0003-1134-7475, Desmond Tutu HIV Foundation), J Moody (0000-0002-3311-4173, Duke University), Nicholas Musinguzi (0000-0002-1269-4623, Mbarara University of Science and Technology), Mwebesa Bwana (0000-0002-9189-3937, Mbarara University of Science and Technology), David R Bangsberg (0000-0002-6352-8908, VinUniversity), Jessica E Haberer (0000-0001-5845-3190, Massachusetts General Hospital), Alexander C Tsai (0000-0001-6397-7917, Massachusetts General Hospital), N C Ware (0000-0002-5039-9991), Elioda Tumwesigye
Year2024
Volume25
Pages101593-101593
Publication date2024-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSSM - Population Health (JOURNAL)
Journal identifiersISSN: 2352-8273 • E-ISSN: 2352-8273
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.ssmph.2023.101593
PMID38292051
OpenAlexW4390480367
LanguageEN
Citations received9
References cited65

Timely initiation of and adherence to antiretroviral therapy (ART) is critical for improving HIV outcomes and reducing HIV transmissibility. Social networks, or the social relationships individuals have with each other, have been linked with positive health outcomes, but less is known about the extent to which social network composition and structure are associated with improved ART adherence among people living with HIV (PLWH). We conducted an ego-centric network study among 828 previously ART-naïve PLWH presenting for ART initiation at 11 clinics in Mbarara, Uganda (rural population) and Gugulethu, South Africa (peri-urban population). We collected social network data using name generator and name interpreter questions. ART adherence was monitored over 12 months using wireless monitors (Wisepill). Our primary outcome of interest was ART adherence during the 12-month follow-up period. We used generalized linear models to estimate the associations between network measures and ART adherence. PLWH at the Uganda site (compared with the South Africa site) were less isolated, had larger social networks, and had more social ties providing sufficient social support; they were also more likely to bridge different social groups whereby not all social ties were connected to each other. In Uganda, social isolation was associated with a 5.5 percentage point reduction in ART adherence (95% confidence interval [CI] -9.95 to -1.13; p = 0.014), while having more same gender social ties was associated with higher ART adherence (b = 0.13, 95% CI 0.02-0.25, p = 0.025). In South Africa, there was no association between social isolation and ART adherence, and having more friendship ties (vs. family ties) was associated with lower ART adherence (b = -2.20, 95% CI -3.56 to -0.84; p = 0.002). Identifying and supporting PLWH who are isolated may facilitate optimal adherence, but understanding how networks differentially affect ART adherence by country context is important

Environmental health · Interpersonal ties · Political science · Population · Psychiatry · Psychological intervention · Social isolation · Social media · Social network (sociolinguistics · Social support · Sociology · Adolescent Sexual and Reproductive Health · Demography · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Psychology · Social Psychology