A network analysis of positive psychosocial factors and indication of suboptimal HIV care outcomes among Black women living with HIV

ABSTRACT

Black women living with HIV (BWLWH) face barriers that impact health outcomes. However, positive psychosocial indicators may influence HIV care outcomes. Among this cross-sectional study of 119 BWLWH, a network analysis was utilized to examine relationships between positive psychosocial factors and HIV-related health outcomes. A preliminary polychoric analysis was conducted to examine correlations between the variables, and the network analyzed connections between resilience, self-efficacy, self-esteem, perceived social support, religious coping, post-traumatic growth, and an indicator variable for suboptimal HIV care outcomes (low medication adherence, detectable viral load, and missed HIV-related health visits) and determined the centrality measures within the network. Seven significant associations were found among the factors: self-efficacy and self-esteem, post-traumatic growth and resilience, post-traumatic growth and self-efficacy, post-traumatic growth and religious coping, perceived social support and resilience, self-esteem and resilience, self-esteem and perceived social support (bootstrapped 95% CI did not contain zero). Self-efficacy was the strongest indicator associated with the other factors. Although not statistically significant, the indicator for suboptimal HIV care outcomes was negatively associated with perceived social support and religious coping. Future interventions incorporating self-efficacy may be beneficial to the overall well-being of Black women.

KEYWORDS:

• Black women
• HIV
• network analysis
• reduced inequalities
• good health and well-being

Acknowledgements

We would like to extend extensive gratitude to the women who participated in this study, community stakeholders, and research staff. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure statement

Unrelated to data in this manuscript, Dr. Dale is a coinvestigator on a Merck & Co. funded project on “A Qualitative Study to Explore Biomedical HIV Prevention Preferences, Challenges and Facilitators among Diverse At-Risk Women Living in the United States” and has served as a workgroup consultant on engaging people living with HIV for Gilead Sciences, Inc.

Informed consent

Informed consent was obtained for all enrolled participants.

Research involving human subjects

The study protocol was approved by the University of Miami’s Institutional Review Board.

Author contributions statement

S. K. Dale, the study’s principal investigator, developed the study hypotheses and procedures for data collection, oversaw the study team, provided the conceptual underpinning to inform analyses and interpret findings, provided iterative feedback and edits to the article, and worked closely with C. C. Chuku. C. C. Chuku drafted the article and ran all analyses with insights from J. Lee. J. Lee also reviewed the article and provided feedback. M.F. Silva helped with drafting, formatting, and reviewing the article. K. Lazarus and R. Reid were instrumental in data collection and provided feedback on the article. A. Carrico provided ongoing insights and reviewed the article.

Additional information

Funding

The research reported in this publication and the principal investigator (Dr. Sannisha Dale) were funded by K23MH108439 from the National Institute of Mental Health (NIMH ). Dr. Dale was additionally funded by R56MH121194 and R01MH121194 from NIMH.