Failure to remain in care and adhere to antiretroviral therapy (ART) over time has significant impacts on individuals'treatment response, health and quality of life and often leads to substantial lifestyle adjustments, including isolation, job loss, and depression. We know that a significant barrier to remaining in care and adhering to treatment is the stigma associated with HIV/AIDS. Conversely, social support and disclosure of serostatus are associated with safer sex, HIV testing, initiating and staying in HIV care and adherence to ART. Although researchers of stigma, social support and HIV disclosure commonly refer to social networks in discussing the implications of their findings, we are unaware of any systematic studies that investigate the relationship between social network characteristics and stigma, social support or disclosure. Drawing on sociological and psychological frameworks, the proposed 2-year study will follow 100 urban and 100 rural HIV+ individuals who recently initiated HIV care. We will: (1) examine patterns in personal social network size, composition and structure and how these change over time in the context of receiving HIV care and for some, ART;(2) identify and describe disclosure patterns among respondents and how these vary across types of individuals and over time;(3) explore the relationships between individuals'perceptions of stigma, social support and disclosure patterns and their network characteristics;and (4) investigate to what degree network characteristics, stigma, disclosure and social support are associated with treatment retention and adherence to care. These findings could provide critical information for the development of interventions and public health policy aimed at reducing perceived stigma, increasing social support and disclosure, and improving HIV care retention and adherence among those infected with HIV/AIDS.
This study is important to public health as its findings could provide critical information for the development of interventions and public health policy aimed at reducing perceived stigma and increasing social support and disclosure for those who infected with HIV/AIDS. By intervening on these fundamental mechanisms, it would be to help individuals remain in care and adhere to treatment over time and significantly improve individuals'treatment response, health and quality of life.