title: Social Network Characteristics Moderate the Association Between Stigmatizing Attributions About HIV and Non-adherence Among Black Americans Living with HIV: a Longitudinal Assessment.
abstract: BACKGROUND
  Stigma may contribute to HIV-related disparities among HIV-positive Black Americans.
  
  
  OBJECTIVE
  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.
authors: Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA, USA.|Department of Pediatrics, Harvard Medical School, Boston, MA, USA.|Health Unit, RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA.
authors: Laura M
authors: LM
authors: Bogart
authors: Health Unit, RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA.
authors: Glenn J
authors: GJ
authors: Wagner
authors: Health Unit, RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA, 90407-2138, USA. hgreen@rand.org.
authors: Harold D
authors: HD
authors: Green
authors: Department of Sociology, California State University, Dominguez Hills, Long Beach, CA, USA.|Community-Based Research, AIDS Project Los Angeles, Los Angeles, CA, USA.
authors: Matt G
authors: MG
authors: Mutchler
authors: Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
authors: David J
authors: DJ
authors: Klein
authors: Department of Sociology, California State University, Dominguez Hills, Long Beach, CA, USA.|Community-Based Research, AIDS Project Los Angeles, Los Angeles, CA, USA.|Clinical Psychology, Pacifica Graduate Institute, Carpinteria, CA, USA.
authors: Bryce
authors: B
authors: McDavitt
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D057545:Social Stigma; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: Adherence; African American/Black; Discrimination; Disparities; HIV/AIDS; Social networks; Stigma