Social Network Approaches to Recruitment, HIV Prevention, Medical Care, and Medication Adherence

ArticleinJAIDS Journal of Acquired Immune Deficiency Syndromes 63 Suppl 1(Suppl 1):S54-8 · June 2013with21 Reads
DOI: 10.1097/QAI.0b013e3182928e2a · Source: PubMed
Abstract
: This article reviews the current issues and advancements in social network approaches to HIV prevention and care. Social network analysis can provide a method to understand health disparities in HIV rates, treatment access, and outcomes. Social network analysis is a valuable tool to link social structural factors to individual behaviors. Social networks provide an avenue for low-cost and sustainable HIV prevention interventions that can be adapted and translated into diverse populations. Social networks can be utilized as a viable approach to recruitment for HIV testing and counseling, HIV prevention interventions, optimizing HIV medical care, and medication adherence. Social network interventions may be face-to-face or through social media. Key issues in designing social network interventions are contamination due to social diffusion, network stability, density, and the choice and training of network members. There are also ethical issues involved in the development and implementation of social network interventions. Social network analyses can also be used to understand HIV transmission dynamics.
    • "Reaching a large number of men quickly may be a worthwhile strategy in sub-Saharan Africa where many more men need to know their HIV status. Targeting naturally occurring networks, like the camps in this study, is a feasible and effective intervention approach because it facilitates access to men in settings where they regularly socialize [23, 65]. Future studies should assess whether network interventions can effectively scale up HIV testing for men in sub-Saharan Africa. "
    [Show abstract] [Hide abstract] ABSTRACT: Men in sub-Saharan Africa have low HIV testing rates. Social networks exert an important influence on men’s HIV-related behavior. We examined associations between network factors and HIV testing among men in Dar es Salaam, Tanzania. Data are from the baseline assessment of an HIV prevention trial with 48 primarily male networks. Among 923 sexually active men, 52 % had ever tested for HIV. In a random effects logistic regression model, men in the network core were 1.50 times more likely (p < .05) to test than those in the periphery. Percentage of women in the network was associated with men’s increased HIV testing (AOR 4.24, p < .05). Perception of network HIV stigma was negatively associated with HIV testing (AOR 0.92, p < .01). Thinking at least one close friend tested for HIV was associated with increased testing (AOR 2.66, p < .001). Social network interventions are a promising approach for scaling up men’s HIV testing.
    Full-text · Article · Aug 2016
    • "Approaches that systematically identify, train, and enlist known social influence leaders to advise members of their own networks in risk reduction constitute effective ways to reach hidden, marginal population segments, such as African American MSM and TG women (Amirkhanian, Kelly, Kabakchieva, McAuliffe, & Vassileva, 2003; Kelly et al., 1997). Social support is related to increased HIV treatment adherence and retention in care, and even social support interventions that take place via online networks have been shown to have impact (Latkin et al., 2013). Thus, it would appear that engaging with African American MSM and TG social networks, such as the extant networks within the HBC, and measuring the forms of social support within these networks and their association with norms and behaviours would be an essential step in promoting HIV prevention within this particular community. "
    [Show abstract] [Hide abstract] ABSTRACT: The House Ball Community (HBC) is an understudied network of African American men who have sex with men and transgender women, who join family-like houses that compete in elaborate balls in cities across the United States. From 2011 to 2012, we surveyed 274 recent attendees of balls in the San Francisco Bay Area, focusing on social networks, social support, and HIV-related behaviours. Participants with a high percentage of alters who were supportive of HIV testing were significantly more likely to have tested in the past six months (p = .02), and less likely to have engaged in unprotected anal intercourse (UAI) in the past three months (p = .003). Multivariate regression analyses of social network characteristics, and social support, revealed that testing in the past six months was significantly associated with social support for safer sex, instrumental social support, and age. Similarly, UAI in the past three months was significantly associated with social support for safer sex, homophily based on sexual identity and HIV status. HIV-related social support provided through the HBC networks was correlated with recent HIV testing and reduced UAI. Approaches utilising networks within alternative kinship systems, may increase HIV-related social support and improve HIV-related outcomes.
    Full-text · Article · May 2016
    • "Most importantly, these SNIs all used social networks that were defined by the study participants themselves. The Community Popular Opinion Leader (CPOL) or the Targeted Outreach Intervention (TOI) models chose leaders from the community with a possibility of missing smaller yet critical social networks that impact one's daily interactions [92, 97]. In most of the reviewed SNIs, the network members were either directly involved in the intervention or indirectly when receiving information from the peers. "
    [Show abstract] [Hide abstract] ABSTRACT: Social network analysis (SNA) and social network-based interventions (SNI) are important analytical tools harnessing peer and family influences critical for HIV prevention and treatment among substance users. While SNA is an effective way to measure social network influences, SNI directly or indirectly involves network members in interventions. Even though these methods have been applied in heterogeneous ways, leading to extensive evidence-based practices, systematic reviews are however, lacking. We searched five bibliographic databases and identified 58 studies involving HIV in substance users that had utilized SNA or SNI as part of their methodology. SNA was used to measure network variables as inputs in statistical/mathematical models in 64 % of studies and only 22 % of studies used SNI. Most studies focused on HIV prevention and few addressed diagnosis (k = 4), care linkage and retention (k = 5), ART adherence (k = 2), and viral suppression (k = 1). This systematic review highlights both the advantages and disadvantages of social network approaches for HIV prevention and treatment and gaps in its use for HIV care continuum.
    Full-text · Article · Apr 2016
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