Allison R. Webel, PhD, RNIAS, 2011Abstract MOAC0105August 18, 2011

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A Description of Social Capital in Persons Living with HIV/AIDS

Disclosure/Conflicts of Interest

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• None to declare

• The contents of this presentation are solely the views of the authors and do not necessarily represent the official views of the National Institutes of Health.

Background

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• “Aggregate or potential resources which are linked to possession of a durable network of more or less institutionalized relationships of mutual acquaintance or recognition”1-2

• Aspects of social capital have been linked to reduced HIV transmission behaviors3-5

• Studies used different methods of assessment of social capital

• Literature lacks a general description of social capital, and a description of its health correlates, in a diverse sample of PLWH

1:Bourdieu 1985, p248;2:Portes, 1998; 3: Bhattacharya., 2005; 4: Frumence, 2010;5: Pronyk et al., 2008

Research Aims

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• Describe levels of social capital in an international sample of adults living with HIV/AIDS;

• Provide evidence for the validity of the individual-level, Social Capital Scale in this population; and

• Determine the nature of associations between social capital, physical and psychological health, social support, and HIV status among PLWH.

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Results

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Demographic Information (n=1,963)

Frequency (%) Mean (+/- SD)

Age (years) 45.2 (9.4)

Gender

Male 1,341 (69.0)

Female 552 (28.4)

Transgender 45 (2.3)

Race Asian/Pacific

Islander 230 (11.9) African

American/Black 755 (39.9)

Hispanic/Latino 400 (20.7)

White/Angelo 439 (22.7)

Education Level

11th grade or less 544 (28.0)

High School or GED 746 (38.3)

2 yrs college/AA 411 (21.1)

4 yrs college/BS/BA 193 (9.9)

Self-Reported HIV Indicators (n=1,963)

Frequency (%) Mean (+/- SD)

Year Dx’d with HIV 1998 (7.4)

Prescribed ART 1,578 (80.4)

Has AIDS Diagnosis 816 (42.5) Undetectable Viral Load 1,716 (87.4)

Viral Load 29,406 (87,605)

HIV Transmission MethodSex with a man with

HIV 1,286 (71.1%) Sex with a woman

with HIV 465 (28.5)

Sharing needles 482 (28.8)

Blood transfusion 174 (10.9)

Do not know 165 (11.5)

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Research Aims

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• Describe levels of social capital in an international sample of adults living with HIV/AIDS;

• Provide evidence for the validity of the individual-level, Social Capital Scale in this population; and

• Determine the nature of associations between social capital, physical and psychological health, social support, and HIV status among PLWH.

Results

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Summary: Aim 1 Results

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• Increased social capital in PLWH than previously reported

• Differences by geographic region; and

• Suggests a relationship between social capital and perceived health in PLWH

Research Aims

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• Describe levels of social capital in an international sample of adults living with HIV/AIDS;

• Provide evidence for the validity of the individual-level, Social Capital Scale in this population; and

• Determine the nature of associations between social capital, physical and psychological health, social support, and HIV status among PLWH.

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Principle Components Factor Analysis with (Promax) Oblique Rotation

Factor Items Eigenvalue Percent Variance Explained

Factor 1: Participation in the Local Community

6 4.59 14.8

Factor 2: Friends and Family 9 4.43 14.3

Factor 3: Tolerance and Diversity 5 3.39 12.6

Factor 4: Neighborhood Connections 4 2.87 9.3

Factor 5: Feelings of Trust and Safety 4 2.3 7.4

Nonloading Items 3 2.18 7

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Research Aims

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• Describe levels of social capital in an international sample of adults living with HIV/AIDS;

• Provide evidence for the validity of the individual-level, Social Capital Scale in this population; and

• Determine the nature of associations between social capital, physical and psychological health, social support, and HIV status among PLWH.

Bivariate Correlation Coefficients1 between Social Capital and Mental Health Variables Adult PLWH

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Country Sample Size

Mental Health QoL

Depression CESD

Anxiety IVDU Alcohol Use

Canada 100 -0.03 -0.01 -0.08 0.12 -0.12China 107 0.08 -0.005 -0.15 -0.03 0Namibia 102 0.005 0.08 -0.11 0.11 0.19Puerto Rico 100 0.14 0.10 -0.15 -0.10 -0.22Thailand 100 0.15 0.14 -0.18 0.11 0.18United States 1,454 0.01 -0.01 -0.02 0.02 0.03Total 1,963 0.02 -0.002 -0.05 0.02 0.03

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1Range -1 to 1 where 0 indicates no relationship and -1/1 indicated a strong relationship

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Bivariate Correlation Coefficients1 between Social Capital and Self-Reported Health Condition in PLWH

Country Sample Size Physical Condition

Psychological Condition

Social Support

Canada 100 0.17 0.21 0.25China 107 0.28 0.21 0.34Namibia 102 0.35 0.35 0.33Puerto Rico 100 0.06 0.17 0.25Thailand 100 0.03 0.26 0.30United States 1,454 0.25 0.32 0.37Total 1,963 0.25 0.31 0.36

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1Range -1 to 1 where 0 indicates no relationship and -1/1 indicated a strong relationship

Limitations

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• Convenience sampling

• Modification of the Social Capital Scale

• Mainly U.S.-based sites

Summary of our findings

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• This is the first report to quantitatively describe levels of total social capital in a large, international sample of PLWH;

• Researchers can be confident that the Social Capital Scale is an appropriate measure of social capital in PLWH;

• Our findings add to the growing evidence of the relationship between social capital and health, uniquely describing this relationship in PLWH;

• Health interventions that emphasize increasing total social capital in PLWH can be built upon our descriptive findings

Acknowledgements

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J. Craig Philips, PhDUniversity of British Columbia

Carol Dawson Rose, PhDMallory Johnson, PhDCarmen Portillo, PhDUniversity of California, San Francisco

William L. Holzemer, PhDLucille Eller, PhDDean Wantland, PhDRutgers College of Nursing

Wei-Ti Chen, DNScYale University

Lynda Tyer-Viola, PhDInge B. Corless, PhDMGH Institute of Health Professions

Marta Rivero-Mendez, DNSUniversity of Puerto Rico

Patrice Nicholas, DNScBrigham and Women's Hospital

Kathleen Nokes, PhD

Hunter College, CUNY

Jeanne Kemppainen, PhDUniversity of North Carolina Wilmington

Scholastika Iipinge, PhDUniversity of Namibia

Kenn Kirksey, PhDSeton Family of Hospitals

Puangtip Chaiphibalsarisdi, PhDSuan Sunandha Rajabhat University

Joachim Voss, PhDUniversity of Washington

Robert A. Salata, MDCase Western Reserve University

Members of the International HIV/AIDS Nursing Research Network

Acknowledgements

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This project was supported in part by:

NIH UL1 RR024131; NIH T32NR007081; NIH KL2RR024990; NIH R15NR011130;

International Pilot Award, University of Washington CFAR; University of British

Columbia School of Nursing Helen Shore Fund;

Duke University School of Nursing Office of Research Affairs; Rutgers College of Nursing; andCity University of New York.

Theses funding agencies had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication