Laura M Bogart1,2,3, Glenn J Wagner3, Harold D Green4, Matt G Mutchler5,6, David J Klein1, Bryce McDavitt5,6,7. 1. Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA, USA. 2. Department of Pediatrics, Harvard Medical School, Boston, MA, USA. 3. Health Unit, RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA. 4. Health Unit, RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA. hgreen@rand.org. 5. Department of Sociology, California State University, Dominguez Hills, Long Beach, CA, USA. 6. Community-Based Research, AIDS Project Los Angeles, Los Angeles, CA, USA. 7. Clinical Psychology, Pacifica Graduate Institute, Carpinteria, CA, USA.
Abstract
BACKGROUND: Stigma may contribute to HIV-related disparities among HIV-positive Black Americans. PURPOSE: We examined whether social network characteristics moderate stigma's effects. METHODS: At baseline and 6 months post-baseline, 147 HIV-positive Black Americans on antiretroviral treatment completed egocentric social network assessments, from which we derived a structural social support capacity measure (i.e., ability to leverage support from the network, represented by the average interaction frequency between the participant and each alter). Stigma was operationalized with an indicator of whether any social network member had expressed stigmatizing attributions of blame or responsibility about HIV. Daily medication adherence was monitored electronically. RESULTS: In a multivariate regression, baseline stigma was significantly related to decreased adherence over time. The association between stigma and non-adherence was attenuated among participants who increased the frequency of their interactions with alters over time. CONCLUSIONS: Well-connected social networks have the potential to buffer the effects of stigma.
BACKGROUND: Stigma may contribute to HIV-related disparities among HIV-positive Black Americans. PURPOSE: We examined whether social network characteristics moderate stigma's effects. METHODS: At baseline and 6 months post-baseline, 147 HIV-positive Black Americans on antiretroviral treatment completed egocentric social network assessments, from which we derived a structural social support capacity measure (i.e., ability to leverage support from the network, represented by the average interaction frequency between the participant and each alter). Stigma was operationalized with an indicator of whether any social network member had expressed stigmatizing attributions of blame or responsibility about HIV. Daily medication adherence was monitored electronically. RESULTS: In a multivariate regression, baseline stigma was significantly related to decreased adherence over time. The association between stigma and non-adherence was attenuated among participants who increased the frequency of their interactions with alters over time. CONCLUSIONS: Well-connected social networks have the potential to buffer the effects of stigma.
Entities:
Keywords:
Adherence; African American/Black; Discrimination; Disparities; HIV/AIDS; Social networks; Stigma
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