Social Support, Stigma and Disclosure: Examining the Relationship with HIV Medication Adherence among Ryan White Program Clients in the Mid-South USA.

Latrice Pichon,Lisa Krull,Dorcas Griffin,Siri Ogg,Kristen Rossi

doi:10.3390/ijerph120607073

Abstract

Social support from friends and family is positively related to better health outcomes among adults living with HIV. An extension of these networks such as religious communities may be an untapped source of social support for promoting HIV medical adherence. This paper explores the association of HIV medication adherence to satisfaction with support from family, friends and church members, as well as HIV-related stigma, and HIV disclosure. In partnership with the Shelby County Health Department, the Memphis Ryan White Part A Program, and the University of Memphis School of Public Health, a total of 286 interviewer-administered surveys were conducted with Ryan White clients. Seventy-six percent (n = 216) of participants reported being prescribed antiretroviral medication (ARVs). Nearly all participants (n = 202, 94%) prescribed ARVs reported disclosing their HIV status to someone. Almost 20% (n = 40) of those prescribed ARVs reported not being satisfied with support received from his/her church. Interestingly, participants reported rarely experiencing stigma as a result of their HIV status. The extent to which satisfaction with support from personal networks and institutional settings like the church affect medication adherence is yet to be understood. The complexity of HIV disclosure and HIV stigma in relation to these supports warrants further investigation to understand how best to improve HIV health outcomes.

Highlights

Anti-Retroviral therapy has been proven effective in reducing mortality from HIV, transforming the disease into a manageable chronic illness rather than a terminal diagnosis [1] the treatment is only effective with a strict level of medical adherence
Outcomes, including medication adherence, focuses on the support provided by family and partners, but it may be important to consider an expanded social support network, including that provided by a church
This paper aims to examine the association of HIV medication adherence to satisfaction with support provided by various social network members, including family, friends, and church members, as well as HIV-related stigma and HIV disclosure

Summary

Introduction

Anti-Retroviral therapy has been proven effective in reducing mortality from HIV, transforming the disease into a manageable chronic illness rather than a terminal diagnosis [1] the treatment is only effective with a strict level of medical adherence. While increased knowledge about the disease, positive expectations of treatment efficacy, and less complicated drug regimens facilitate adherence [2], medication side effects, life responsibilities and stressors, and depression may diminish compliance [3]. The role of social support is complicated and not fully understood in this context [4], it may affect adherence. Social support is positively related to better health outcomes in several disease contexts. Numerous types of support, their sources and pathways, make it difficult to pinpoint how this process is fully manifested, especially in relation to HIV [5]. Much of the literature on social support and HIV outcomes, including medication adherence, focuses on the support provided by family and partners, but it may be important to consider an expanded social support network, including that provided by a church

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