Social networks and mental health among people living with human immunodeficiency virus (HIV) in Johannesburg, South Africa

Abstract

People living with human immunodeficiency virus (PLHIV) in developing countries can live longer due to improved treatment access, and a deeper understanding of determinants of their quality of life is critical. This study assessed the link between social capital, operationally defined in terms of social networks (group-based and personal social networks) and access to network resources (access to material and non-material resources and social support) and health-related quality of life (HRQoL) among 554 (55% female) adults on HIV treatment through South Africa's public health system. Female study participants were involved with more group-based social networks but had fewer personal social networks in comparison to males. Access to network resources was higher among females and those from larger households but lower among older study participants. Experience of social support significantly increased with household economic status and duration at current residence. Social capital indicators were unrelated to HIV disease status indicators, including duration since diagnosis, CD4 count and viral load. Only a minority (13%) of study participants took part in groups formed by and for predominantly PLHIV (HIV support groups), and participation in such groups was unrelated to their mental or physical health. Personal rather than group-linked social networks and access to network resources were significantly associated with mental but not physical health, after controlling for sociodemographic characteristics. The findings of limited participation in HIV support groups and that the participation in such groups was not significantly associated with physical or mental health may suggest efforts among PLHIV in South Africa to normalise HIV as a chronic illness through broad-based rather than HIV-status bounded social participation, as a strategy for deflecting stigma. Further research is required to examine the effects of HIV treatment on social networking and participation among PLHIV within both rural and other urban settings of South Africa.

Keywords:

• social capital
• people living with HIV
• South Africa
• mental health
• health-related quality of life

Acknowledgements

A special appreciation is expressed to the Aurum Institute for Health Research, South Africa, through Dr Salome Charalambous, for providing financial and logistical support for the implementation of this study. The support of Dr S.B. Mfenyana, Chief Executive Officer, Tembisa Hospital and Dr Alan Karstaedt, Chris Hani-Baragwanath Hospital, with accessing the health facilities and the contributions to the day-to-day implementation of the study of Sister Violet Ramalapa and Sister Gertrude Monkoe, of the two hospitals, respectively, are highly appreciated. We thank the data collectors and data managers, namely, Ms Lebo Ramatsa, Ms Phendulwa Myeki, Mr Sibusiso Sadike, Mr Xolani Nkos, Mr Lihle Mchunu and Ms Dineo Matsemela for their dedication to the study.