Postdoctoral Fellow University of California, San Francisco
Abstract Title
Intersectional social network support experiences, barriers, facilitators, and intervention opportunities among Black cisgender and transgender women living with HIV in the U.S. South
Abstract Authors
Miranda Hill
Author Affiliations
University of California, San Francisco
Background
Black cisgender and transgender women living with HIV (BWLH) in the US South bear the brunt of domestic HIV morbidity and mortality inequities among women. Social networks, defined as interconnected relationships, significantly impact health outcomes across the lifespan. Leveraging these networks can enhance health outcomes for BWLH by strengthening social support within their daily lives. However, interventions utilizing existing social networks in health and service promotion efforts among BWLH are lacking. This study aims to address knowledge gaps in the social and cultural context of BWLH's support experiences and opportunities for network-based interventions to improve HIV outcomes.
Methods
A purposive sampling strategy was employed to recruit 18 Black/African American women living with HIV in Georgia, including 6 cisgender, 7 transgender, and 5 with feminine/non-disclosed identities, for qualitative in-depth interviews. These interviews, lasting 60-90 minutes on average, explored their personal network support experiences, barriers, and facilitators. Thematic analyses of cultural, intrapersonal, and interpersonal factors shaping network support mobilization were conducted using an interdisciplinary symbolic interactionist and intersectionality lens.
Results
There were complex intersections in support mobilization and access experiences among cis and trans women. Both groups reported belonging to disconnected networks offering various types of support, with trans women often having larger networks due to broader connections. Key themes emerged, including (1) the superwoman schema and the negotiation of independence and role strain, (2) the role of maternal figures in facilitating support-seeking and acceptance, (3) the importance of multidimensional trust in brokering network support mobilization, and (4) the preference for informal online and community-driven peer support networks for tailored HIV-specific support with autonomy and discretion.
Conclusion(s)
Study findings highlight culturally and socially interactive mechanisms influencing social network support mobilization among BWLH, with implications for syndemic stress, depression, and HIV care outcomes. Addressing factors like cultural self-schemas, gender-power dynamics, and trust-oriented relationships is crucial through individualized relationship-stress management and family-oriented support programs. Moreover, intergenerational maternal-oriented support and online/community-based peer network models show promise in promoting various health outcomes among BWLH across their lifespan. Further research can elucidate these mechanisms and lead to culturally relevant network-based strategies for advancing HIV equity among BWLH in the South.