Characteristics of Social Support Amongst People with HIV in Extreme Poverty in Lima, Peru: An Exploratory Study at the Beginning of HAART

Background: Studies show that social support positively influences people's adherence to antiretrovirals, while stigma and poverty have profound negative effects on adherence and treatment outcome. This study explores how people living in extreme poverty experience social support when diagnosed with HIV and starting highly-active antiretroviral therapy (HAART). Methods: Embedded in a larger study that assesses the effect of community-based accompaniment for people living with HIV (PLH), this is a cross sectional and exploratory study using purposive sampling of 15 PLH and their corresponding treatment supporters, i.e. a friend, partner or family member identified by the PLH as a requisite for starting treatment. Participants were interviewed using a semi-structured guide within a month of starting HAART. PLH were interviewed separately from their supporters. Qualitative analysis was used to identify themes related to social support, disclosure, and changes in social responsibility when receiving the diagnosis and starting treatment. Results: Key informal social networks were used by PLH for essential logistical and emotional support. Decisions related to disclosure and changes in PLH's social roles as a result of their diagnosis and illness resulted in changes in their social networks. Treatment supporters provided an important form of support for PLHs during this transitional time. Conclusion: At the time of diagnosis and HAART initiation, social support is imperative for the emotional and physical health of PLH. The specifics of the findings may inform programs promoting adherence to establish a strong support system accessible to the person with HIV.