A cross-sectional description of social capital in an international sample of persons living with HIV/AIDS (PLWH)

Frances Payne Bolton School of Nursing Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4904, USA.
BMC Public Health (Impact Factor: 2.26). 03/2012; 12(1):188. DOI: 10.1186/1471-2458-12-188
Source: PubMed


Social capital refers to the resources linked to having a strong social network. This concept plays into health outcomes among People Living with HIV/AIDS because, globally, this is a highly marginalized population. Case studies show that modifying social capital can lead to improvements in HIV transmission and management; however, there remains a lack of description or definition of social capital in international settings. The purpose of our paper was to describe the degree of social capital in an international sample of adults living with HIV/AIDS.
We recruited PLWH at 16 sites from five countries including Canada, China, Namibia, Thailand, and the United States. Participants (n = 1,963) completed a cross-sectional survey and data were collected between August, 2009 and December, 2010. Data analyses included descriptive statistics, factor analysis, and correlational analysis.
Participant's mean age was 45.2 years, most (69%) identified as male, African American/Black (39.9%), and unemployed (69.5%). Total mean social capital was 2.68 points, a higher than average total social capital score. Moderate correlations were observed between self-reported physical (r = 0.25) and psychological condition (r = 0.36), social support (r = 0.31), and total social capital. No relationships between mental health factors, including substance use, and social capital were detected.
This is the first report to describe levels of total social capital in an international sample of PLWH and to describe its relationship to self-reported health in this population.

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    • "The parent study was also approved at sites in China, Namibia, and Thailand by the Shanghai Public Health Clinic Center Institution Review Board; Ethics Committee of the Ministry of Health and Social Services, Namibia; Ethics Committee of the University of Namibia; and The Ethical Committee of Lerdsin Hospital, Governmental Hospital, Bangkok, Thailand. The demographic characteristics and methods of this study have been previously published [37,58,61]. Selected demographic, survey, and environmental contextual data relevant to the aims of this study are presented. "
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    ABSTRACT: Human rights approaches to manage HIV and efforts to decriminalize HIV exposure/transmission globally offer hope to persons living with HIV (PLWH). However, among vulnerable populations of PLWH, substantial human rights and structural challenges (disadvantage and injustice that results from everyday practices of a well-intentioned liberal society) must be addressed. These challenges span all ecosocial context levels and in North America (Canada and the United States) can include prosecution for HIV nondisclosure and HIV exposure/transmission. Our aims were to: 1) Determine if there were associations between the social structural factor of criminalization of HIV exposure/transmission, the individual factor of perceived social capital (resources to support one's life chances and overcome life's challenges), and HIV antiretroviral therapy (ART) adherence among PLWH and 2) describe the nature of associations between the social structural factor of criminalization of HIV exposure/transmission, the individual factor of perceived social capital, and HIV ART adherence among PLWH. We used ecosocial theory and social epidemiology to guide our study. HIV related criminal law data were obtained from published literature. Perceived social capital and HIV ART adherence data were collected from adult PLWH. Correlation and logistic regression were used to identify and characterize observed associations. Among a sample of adult PLWH (n = 1873), significant positive associations were observed between perceived social capital, HIV disclosure required by law, and self-reported HIV ART adherence. We observed that PLWH who have higher levels of perceived social capital and who live in areas where HIV disclosure is required by law reported better average adherence. In contrast, PLWH who live in areas where HIV transmission/exposure is a crime reported lower 30-day medication adherence. Among our North American participants, being of older age, of White or Hispanic ancestry, and having higher perceived social capital, were significant predictors of better HIV ART adherence. Treatment approaches offer clear advantages in controlling HIV and reducing HIV transmission at the population level. These advantages, however, will have limited benefit for adherence to treatments without also addressing the social and structural challenges that allow HIV to continue to spread among society's most vulnerable populations.
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    • "This study population fit the characteristic profile of high psychological and physical distress,(40) poor sleep,(66,67) moderate-high HIV adherence self-efficacy,(41) and moderate self-compassion(41) common among PLWH. The results of this pilot study suggest that MABT decreases depression and improves quality of sleep. "
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    • "People were excluded from the study if there was evidence of cognitive impairment, active psychosis, or significant confusion. Data were collected between September 2009 and January 2011 by self-administered questionnaires , with support provided by assistants as needed; computer assisted self-interview (China); or one-to-one interview (Bangkok, Newark, Namibia, and Wilmington) (Webel et al., 2012). "
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