Disclosure avoidance mediates the relationship between social networks and social support among HIV+ individuals
Wednesday, November 6, 2013
Background. Social support provided by social network members is critical to the well-being of HIV+ women of color. However, network members may be unaware of HIV status due to HIV disclosure avoidance. Objective. Using data from the Guide to Healing project, we estimate both direct and indirect effects to evaluate how disclosure avoidance mediates the relationship between social networks and reported social support. Methods. Data were collected from ~150 HIV-positive women of color patients at the University of North Carolina's Infectious Disease clinic (July-December, 2011). General Social Survey questions were modified to elicit egocentric network membership and member characteristics. Interviewers also asked validated questions related to social support, disclosure avoidance and demographics. Measures of network exposure, size, support-provision and disclosure avoidance were constructed. We derived risk differences (RDs) from standard linear regression models, which generated beta coefficients and 95% confidence intervals for the direct and indirect effects related to disclosure avoidance. Results. Women were equally distributed across education categories (less than high school (HS), HS, more than HS) and 65% were <50 years old. About 10% were in non-permanent housing and the majority (72%) was unemployed. In models adjusted for age, education, insurance and employment, both more network ties and having ties who know one's HIV status were associated with higher values of treatment-specific social support. Disclosure avoidance was associated with lower social support. Conclusion. Social networks are understood to be an important source of social support for HIV+ women, but perceived social support is mediated through HIV disclosure.
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health
Describe the relationship between social network characteristics and women’s self-rated social support
Assess the relationship between disclosure avoidance and self-rated social support
Examine the direct and indirect effects of disclosure avoidance on the relationship between social network characteristics and self-rated social support
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am qualified to be an abstract author on the content I am responsible for because I am an epidemiologist who has conducted the analyses and I have been trained in social network analysis.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.