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Social network characteristics and HIV testing among older adults in South Africa

Published online by Cambridge University Press:  10 June 2021

Jin A. Lee Open the ORCID record for Jin A. Lee [Opens in a new window]  and
Markus H. Schafer
Jin A. Lee*
Affiliation:
Department of Sociology, University of Toronto, Toronto, Canada
Markus H. Schafer
Affiliation:
Department of Sociology, University of Toronto, Toronto, Canada
*
*Corresponding author. Email: jinasarah.lee@mail.utoronto.ca
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Abstract

Drawing from theory and research on the role of social networks in promoting or undermining preventative public health measures, this article considers how structural, compositional and functional aspects of older adults’ close social networks are associated with HIV testing in the context of rural South Africa. Analyses use data from the population-based Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) – a sample of rural adults age 40+ (N = 4,660). Results from multiple logistic regression show older South African adults with larger, more heavily non-kin and more literate networks were most likely to report testing for HIV. People whose network members provided frequent information were also most likely to be tested, though interaction effects indicate that this pattern is primarily found among those with highly literate networks. Taken together, the findings reinforce a key insight from social capital perspectives: network resourcefulness – literacy in particular – is crucial for promoting preventative health practice. The synergy between network literacy and informational support reveals the complex interplay between network characteristics in shaping health-seeking behaviour. Continued research is needed on the connection between networks and HIV testing among sub-Saharan older adults, as this population is not currently well served by many public health efforts in the region.

Keywords

HIV testingsocial network characteristicsSouth Africahealth-seeking behaviour
Type
Article
Information
Ageing & Society , Volume 43 , Issue 3 , March 2023 , pp. 499 - 515
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

Apt, NA (2002) Ageing and the changing role of the family and the community: an African perspective. International Social Security Review 55, 39–47.CrossRefGoogle Scholar
Autenrieth, CS, Beck, EJ, Stelzle, D, Mallouris, C, Mahy, M and Ghys, P (2018) Global and regional trends of people living with HIV aged 50 and over: estimates and projections for 2000–2020. PLOS ONE 13, e0207005.CrossRefGoogle ScholarPubMed
Berkman, LF and Syme, SL (1979) Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology 109, 186–204.CrossRefGoogle ScholarPubMed
Berkman, LF, Glass, T, Brissette, I and Seeman, TE (2000) From social integration to health: Durkheim in the new millennium. Social Science & Medicine 51, 843–857.CrossRefGoogle ScholarPubMed
Boydell, N, Buston, K and McDaid, LM (2017) Patterns of HIV testing practices among young gay and bisexual men living in Scotland: a qualitative study. BMC Public Health 17, 660.CrossRefGoogle Scholar
Breier, M, Matsepela, T, Sait, L, Prinsloo, M and Breier, M (1996) Taking literacy for a ride – reading and writing in the taxi industry. In Prinsloo M and Breier M (eds), The Social Uses of Literacy: Theory and Practice in Contemporary South Africa. Bertsham, South Africa: Sached Books, pp. 213–234.CrossRefGoogle Scholar
Cao, B, Saffer, AJ, Yang, C, Chen, H, Peng, K, Pan, SW, Durvasula, M, Liu, C, Fu, H, Ong, JJ, Tang, W and Tucker, JD (2019) MSM behavior disclosure networks and HIV testing: an egocentric network analysis among MSM in China. AIDS and Behavior 23, 1368–1374.CrossRefGoogle ScholarPubMed
Conroy, AA (2014) ‘It means there is doubt in the house’: perceptions and experiences of HIV testing in rural Malawi. Culture, Health & Sexuality 16, 397–411.CrossRefGoogle ScholarPubMed
Conserve, DF, Issango, J, Kilale, AM, Njau, B, Nhigula, P, Memiah, P, Mbita, G, Choko, AT, Hamilton, A and King, G (2019) Developing national strategies for reaching men with HIV testing services in Tanzania: results from the male catch-up plan. BMC Health Services Research 19, 317.CrossRefGoogle ScholarPubMed
Coovadia, H, Jewkes, R, Barron, P, Sanders, D and McIntyre, D (2009) The health and health system of South Africa: historical roots of current public health challenges. The Lancet 374, 817–834.CrossRefGoogle ScholarPubMed
Cremin, I, Cauchemez, S, Garnett, GP and Gregson, S (2012) Patterns of uptake of HIV testing in sub-Saharan Africa in the pre-treatment era. Tropical Medicine & International Health 17, e26–e37.CrossRefGoogle ScholarPubMed
Day, JH, Miyamura, K, Grant, AD, Leeuw, A, Munsamy, J, Baggaley, R and Churchyard, GJ (2003) Attitudes to HIV voluntary counselling and testing among mineworkers in South Africa: will availability of antiretroviral therapy encourage testing? AIDS Care 15, 665–672.CrossRefGoogle ScholarPubMed
Dong, X and Liu, A (2017) Variations between sources of social support and cancer screen behaviors in U.S. Chinese older adults. Journals of Gerontology: Biological Sciences and Medical Sciences 72A, S26–S31.CrossRefGoogle Scholar
Emlet, CA, Gerkin, A and Orel, N (2009) The graying of HIV/AIDS: preparedness and needs of the aging network in a changing epidemic. Journal of Gerontological Social Work 52, 803–814.CrossRefGoogle Scholar
Fitzpatrick, AL, Powe, NR, Cooper, LS, Ives, DG and Robbins, JA (2004) Barriers to health care access among the elderly and who perceives them. American Journal of Public Health 94, 1788–1794.CrossRefGoogle Scholar
Fortenberry, JD, McFarlane, M, Bleakley, A, Bull, S, Fishbein, M, Grimley, DM, Malotte, CK and Stoner, BP (2002) Relationships of stigma and shame to gonorrhea and HIV screening. American Journal of Public Health 92, 378–381.CrossRefGoogle ScholarPubMed
Freeman, LC (2004) The Development of Social Network Analysis: A Study in the Sociology of Science. Vancouver, BC: Empirical Press.Google Scholar
Freeman, E and Anglewicz, P (2012) HIV prevalence and sexual behaviour at older ages in rural Malawi. International Journal of STD & AIDS 23, 490–496.CrossRefGoogle ScholarPubMed
Granovetter, M (1983) The strength of weak ties: a network theory revisited. Sociological Theory 1, 201–233.CrossRefGoogle Scholar
Harling, G, Perkins, JM, Gómez-Olivé, FX, Morris, K, Wagner, RG, Montana, L, Kabudula, CW, Bärnighausen, T, Kahn, K and Berkman, L (2018) Interviewer-driven variability in social network reporting: results from Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community (HAALSI) in South Africa. Field Methods 30, 140–154.CrossRefGoogle Scholar
Holt-Lunstad, J, Smith, TB and Layton, JB (2010) Social relationships and mortality risk: a meta-analytic review. PLOS Medicine 7, e1000316.CrossRefGoogle Scholar
Honda, K and Kagawa-Singer, M (2006) Cognitive mediators linking social support networks to colorectal cancer screening adherence. Journal of Behavioral Medicine 29, 449–460.CrossRefGoogle ScholarPubMed
Houle, B, Mojola, SA, Angotti, N, Schatz, E, Gómez-Olivé, FX, Clark, SJ, Williams, JR, Kabudula, C, Tollman, S and Menken, J (2018) Sexual behavior and HIV risk across the life course in rural South Africa: trends and comparisons. AIDS Care 30, 1435–1443.CrossRefGoogle ScholarPubMed
House, JS, Robbins, C and Metzner, HL (1982) The association of social relationships and activities with mortality: prospective evidence from the Tecumseh Community Health Study. American Journal of Epidemiology 116, 123–140.CrossRefGoogle ScholarPubMed
House, JS, Umberson, D and Landis, KR (1988) Structures and processes of social support. Annual Review of Sociology 14, 293–318.CrossRefGoogle Scholar
Huang, ZJ, He, N, Nehl, EJ, Zheng, T, Smith, BD, Zhang, J, McNabb, S and Wong, FY (2012) Social network and other correlates of HIV testing: findings from male sex workers and other MSM in Shanghai, China. AIDS and Behavior 16, 858–871.CrossRefGoogle ScholarPubMed
Huang, D, Hu, Y, Wu, G, Jia, Y, Lu, R, Xiao, Y, Raymond, HF, McFarland, W, Ruan, Y, Ma, W and Sun, J (2014) HIV prevention services and testing utilization behaviors among men who have sex with men at elevated risk for HIV in Chongqing, China. BioMed Research International 2014, 174870.Google ScholarPubMed
Hutchinson, PL and Mahlalela, X (2006) Utilization of voluntary counseling and testing services in the Eastern Cape, South Africa. AIDS Care 18, 446–455.CrossRefGoogle ScholarPubMed
Johnson, B, Redding, C, DiClemente, R, Mustanski, B, Dodge, B, Sheeran, P, Warren, M, Zimmerman, R, Fisher, W, Conner, M, Carey, M, Fisher, J, Stall, R and Fishbein, M (2010) A Network-Individual-Resource model for HIV prevention. AIDS and Behavior 14, 204–221.CrossRefGoogle ScholarPubMed
Kabudula, CW, Houle, B, Collinson, MA, Kahn, K, Gómez-Olivé, FX, Clark, SJ and Tollman, S (2017) Progression of the epidemiological transition in a rural South African setting: findings from population surveillance in Agincourt, 1993–2013. BMC Public Health 17, 424.CrossRefGoogle Scholar
Kahn, K, Collinson, MA, Gomez-Olive, FX, Mokoena, O, Twine, R, Mee, P, Afolabi, SA, Clark, BD, Kabudula, CW, Khosa, A, Khoza, S, Shabangu, MG, Silaule, B, Tibane, JB, Wagner, RG, Garenne, ML, Clark, SJ and Tollman, SM (2012) Profile: Agincourt Health and Socio-demographic Surveillance System. International Journal of Epidemiology 41, 988–1001.CrossRefGoogle ScholarPubMed
Kalichman, SC and Simbayi, L (2004) Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa. AIDS Care 16, 572–580.CrossRefGoogle ScholarPubMed
Keating, NL, O'Malley, AJ, Murabito, JM, Smith, KP and Christakis, NA (2011) Minimal social networks effects evident in cancer screening behavior. Cancer 117, 3045–3052.CrossRefGoogle ScholarPubMed
Kuteesa, MO, Wright, S, Seeley, J, Mugisha, J, Kinyanda, E, Kakembo, F, Mwesigwa, R and Scholten, F (2014) Experiences of HIV-related stigma among HIV-positive older persons in Uganda – a mixed methods analysis. SAHARA-J: Journal of Social Aspects of HIV/AIDS 11, 126–137.CrossRefGoogle ScholarPubMed
Lypen, KD, Lockwood, NM, Shalabi, F, Harper, GW and Ngugi, E (2015) ‘When we are together I feel at home.’ Types and sources of social support among youth newly diagnosed with HIV in Kenya: implications for intervention. African Journal of AIDS Research 14, 275–284.CrossRefGoogle ScholarPubMed
Marquez, B, Elder, JP, Arredondo, EM, Madanat, H, Ji, M and Ayala, GX (2014) Social network characteristics associated with health promoting behaviors among Latinos. Health Psychology 33, 544–553.CrossRefGoogle ScholarPubMed
Mashburn, AJ, Peterson, JL, Bakeman, R, Miller, RL and Clark, LF (2004) Influences on HIV testing among young African-American men who have sex with men and the moderating effect of the geographic setting. Journal of Community Psychology 32, 45–60.CrossRefGoogle Scholar
McFall, SL and Davila, M (2008) Gender, social ties, and cancer screening among elderly persons. Journal of Aging and Health 20, 997–1011.CrossRefGoogle ScholarPubMed
Mills, EJ, Rammohan, A and Awofeso, N (2011) Ageing faster with AIDS in Africa. The Lancet 377, 1131–1133.CrossRefGoogle ScholarPubMed
Molloy, GJ, Perkins-Porras, L, Strike, PC and Steptoe, A (2008) Social networks and partner stress as predictors of adherence to medication, rehabilitation attendance, and quality of life following acute coronary syndrome. Health Psychology 27, 52–58.CrossRefGoogle ScholarPubMed
Nall, A, Chenneville, T, Rodriguez, LM and O'Brien, JL (2019) Factors affecting HIV testing among youth in Kenya. International Journal of Environmental Research and Public Health 16, 1450.CrossRefGoogle ScholarPubMed
Negin, J and Cumming, RG (2010) HIV infection in older adults in sub-Saharan Africa: extrapolating prevalence from existing data. Bulletin of the World Health Organization 88, 847–853.CrossRefGoogle ScholarPubMed
Negin, J, Martiniuk, A, Cumming, RG, Naidoo, N, Phaswana-Mafuya, N, Madurai, L, Williams, S and Kowal, P (2012 a) Prevalence of HIV and chronic comorbidities among older adults. AIDS 26, S55–S63.CrossRefGoogle ScholarPubMed
Negin, J, Nemser, B, Cumming, R, Lelerai, E, Ben Amor, Y and Pronyk, P (2012 b) HIV attitudes, awareness and testing among older adults in Africa. AIDS and Behavior 16, 63–68.CrossRefGoogle ScholarPubMed
Negin, J, Gregson, S, Eaton, JW, Schur, N, Takaruza, A, Mason, P and Nyamukapa, C (2016) Rising levels of HIV infection in older adults in eastern Zimbabwe. PLOS ONE 11, e0162967.CrossRefGoogle ScholarPubMed
Pang, EC, Jordan-Marsh, M, Silverstein, M and Cody, M (2003) Health-seeking behaviors of elderly Chinese Americans: shifts in expectations. The Gerontologist 43, 864–874.CrossRefGoogle ScholarPubMed
Peltzer, K, Matseke, G, Mzolo, T and Majaja, M (2009) Determinants of knowledge of HIV status in South Africa: results from a population-based HIV survey. BMC Public Health 9, 174.CrossRefGoogle ScholarPubMed
Perkins, JM, Subramanian, SV and Christakis, NA (2015) Social networks and health: a systematic review of sociocentric network studies in low- and middle-income countries. Social Science & Medicine 125, 60–78.CrossRefGoogle Scholar
Pitpitan, EV, Kalichman, SC, Eaton, LA, Cain, D, Sikkema, KJ, Skinner, D, Watt, MH and Pieterse, D (2012) AIDS-related stigma, HIV testing, and transmission risk among patrons of informal drinking places in Cape Town, South Africa. Annals of Behavioral Medicine 43, 362–371.CrossRefGoogle ScholarPubMed
Ramadhani, HO, Ndembi, N, Nowak, RG, Ononaku, U, Gwamna, J, Orazulike, I, Adebajo, S, Crowell, TA, Liu, H, Baral, SD, Ake, J and Charurat, ME (2018) Individual and network factors associated with HIV care continuum outcomes among Nigerian MSM accessing health care services. JAIDS: Journal of Acquired Immune Deficiency Syndromes 79, e7–e16.Google ScholarPubMed
Roozenbeek, J, Schneider, CR, Dryhurst, S, Kerr, J, Freeman, ALJ, Recchia, G, van der Bles, AM and van der Linden, S (2020) Susceptibility to misinformation about COVID-19 around the world. Royal Society Open Science 7, 201199.CrossRefGoogle ScholarPubMed
Rouhani, SA, O'Laughlin, KN, Faustin, ZM, Tsai, AC, Kasozi, J and Ware, NC (2017) The role of social support on HIV testing and treatment adherence: a qualitative study of HIV-infected refugees in southwestern Uganda. Global Public Health 12, 1051–1064.CrossRefGoogle ScholarPubMed
Savasta, AM (2004) HIV: associated transmission risks in older adults – an integrative review of the literature. Journal of the Association of Nurses in AIDS Care 15, 50–59.CrossRefGoogle ScholarPubMed
Schatz, E and Knight, L (2018) ‘I was referred from the other side’: gender and HIV testing among older South Africans living with HIV. PLOS ONE 13, e0196158.CrossRefGoogle ScholarPubMed
Shisana, O, Rehle, T, Simbayi, L, Zuma, K, Jooste, S, Zungu, N, Labadarios, D and Onoya, D (2014) South African National HIV Prevalence, Incidence and Behaviour Survey, 2012. Cape Town: HSRC Press.Google Scholar
Siu, GE, Seeley, J and Wight, D (2013) Dividuality, masculine respectability and reputation: how masculinity affects men's uptake of HIV treatment in rural eastern Uganda. Social Science & Medicine 89, 45–52.CrossRefGoogle ScholarPubMed
Siu, GE, Wight, D and Seeley, JA (2014) Masculinity, social context and HIV testing: an ethnographic study of men in Busia district, rural eastern Uganda. BMC Public Health 14, 33.CrossRefGoogle ScholarPubMed
Skevington, SM (2012) Is quality of life poorer for older adults with HIV/AIDS? International evidence using the WHOQOL-HIV. AIDS Care 24, 1219–1225.CrossRefGoogle ScholarPubMed
Skovdal, M, Campbell, C, Nyamukapa, C and Gregson, S (2011) When masculinity interferes with women's treatment of HIV infection: a qualitative study about adherence to antiretroviral therapy in Zimbabwe. Journal of the International AIDS Society 14, 29.CrossRefGoogle ScholarPubMed
Smith-Greenaway, E (2015) Educational attainment and adult literacy: a descriptive account of 31 Sub-Saharan Africa countries. Demographic Research 33, 1015–1034.CrossRefGoogle ScholarPubMed
Smith, KP and Christakis, NA (2008) Social networks and health. Annual Review of Sociology 34, 405–429.CrossRefGoogle Scholar
Snow, RC, Madalane, M and Poulsen, M (2010) Are men testing? Sex differentials in HIV testing in Mpumalanga Province, South Africa. AIDS Care 22, 1060–1065.CrossRefGoogle ScholarPubMed
Song, L and Chang, T-Y (2012) Do resources of network members help in help seeking? Social capital and health information search. Social Networks 34, 658–669.CrossRefGoogle Scholar
Song, L and Lin, N (2009) Social capital and health inequality: evidence from Taiwan. Journal of Health and Social Behavior 50, 149–163.CrossRefGoogle ScholarPubMed
Subramanian, T, Gupte, MD, Mathai, AK, Boopathi, K and Dorairaj, VS (2008) Perception of HIV testing among attendees at an STD clinic in India. AIDS Care 20, 26–34.CrossRefGoogle ScholarPubMed
Takada, S, Weiser, SD, Kumbakumba, E, Muzoora, C, Martin, JN, Hunt, PW, Haberer, JE, Kawuma, A, Bangsberg, DR and Tsai, AC (2014) The dynamic relationship between social support and HIV-related stigma in rural Uganda. Annals of Behavioral Medicine 48, 26–37.CrossRefGoogle ScholarPubMed
Tenkorang, EY, Gyimah, SO, Maticka-Tyndale, E and Adjei, J (2011) Superstition, witchcraft and HIV prevention in sub-Saharan Africa: the case of Ghana. Culture, Health & Sexuality 13, 1001–1014.CrossRefGoogle ScholarPubMed
Umberson, D and Montez, J (2010) Social relationships and health: a flashpoint for health policy. Journal of Health and Social Behavior 51, S54–S66.CrossRefGoogle Scholar
UNAIDS (2014) 90-90-90: An Ambitious Treatment Target to Help End the AIDS Epidemic. Geneva: UNAIDS.Google Scholar
Valente, TW (2010) Social Networks and Health: Models, Methods, and Applications. New York, NY: Oxford University Press.CrossRefGoogle Scholar
Veinot, TC, Caldwell, E, Loveluck, J, Arnold, MP and Bauermeister, J (2016) HIV testing behavior and social network characteristics and functions among young men who have sex with men (YMSM) in Metropolitan Detroit. AIDS and Behavior 20, 2739–2761.CrossRefGoogle ScholarPubMed
Wallrauch, C, Bärnighausen, T and Newell, ML (2010) HIV prevalence and incidence in people 50 years and older in rural South Africa. South African Medical Journal 100, 812–813.CrossRefGoogle ScholarPubMed
Waweru, LM, Kabiru, EW, Mbithi, JN and Some, ES (2003) Health status and health seeking behaviour of the elderly persons in Dagoretti division, Nairobi. East African Medical Journal 80, 63–67.Google ScholarPubMed
White, IR, Royston, P and Wood, AM (2011) Multiple imputation using chained equations: issues and guidance for practice. Statistics in Medicine 30, 377–399.CrossRefGoogle ScholarPubMed
Wreford, J (2009) Worlds apart? Religious interpretations and witchcraft in the negotiation of health strategies for HIV/AIDS in South Africa. Centre for Social Science Research, CSSR Working Paper 262.Google Scholar