Network determinants of relationship influence on HIV prevention decision-making among people in the social networks of women who have experienced incarceration in the US.

<h4>Background</h4>Many cisgender women in the US who have experienced incarceration are at substantial risk for HIV acquisition after they return to the community. Various network interventions have been leveraged for HIV prevention in this population. The objective of this study was to...

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Main Authors: Andrea K Knittel, Gabriel Varela, Ella G Ferguson, Hannah Hulshult, Jamie B Jackson, James Moody, Adaora A Adimora
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0312584
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author Andrea K Knittel
Gabriel Varela
Ella G Ferguson
Hannah Hulshult
Jamie B Jackson
James Moody
Adaora A Adimora
author_facet Andrea K Knittel
Gabriel Varela
Ella G Ferguson
Hannah Hulshult
Jamie B Jackson
James Moody
Adaora A Adimora
author_sort Andrea K Knittel
collection DOAJ
description <h4>Background</h4>Many cisgender women in the US who have experienced incarceration are at substantial risk for HIV acquisition after they return to the community. Various network interventions have been leveraged for HIV prevention in this population. The objective of this study was to identify network and relationship determinants of influence on HIV prevention decisions, including PrEP.<h4>Methods</h4>We conducted interviews with a network mapping exercise with participants recruited from the social and sexual networks of women who had experienced incarceration. Participants enumerated important individuals in their lives from the past six months and provided demographic and relationship data as well as whether each relationship influenced their HIV prevention decisions. We abstracted network data from the interview transcripts and described the data set using descriptive statistics and network density graphs. To measure associations between characteristics at each level and whether a relationship was considered influential regarding PrEP decision-making, we use multiple logistic regression with random intercepts for each respondent.<h4>Results</h4>We interviewed 32 participants, average age 33.5 years (SD = 8.98), majority female (n = 28, 87.5%), white (n = 23, 71.8%), heterosexual/straight (n = 25, 78.1%), and with a personal history of incarceration (n = 29, 90%). They reported 253 relationships (119 family, 116 friend, 18 sexual relationships). Most adult network members had used drugs or alcohol (n = 182, 80.9%), and of those, 30.8% had used them with the participant (n = 53). The mean network size was 7 (SD = 4) and network density was 52.2%. In the full model, significant positive predictors of an influential relationship included participant non-heterosexual identity (OR 27.8), older average age in the network (OR 3.9 per standard deviation), and being a current or prior sexual partner (OR 10.1). Significant negative predictors included relationships with individuals who use or had used drugs (OR 0.28), longer average relationship duration in the network (OR 0.09) and being in a network with at least one sexual partner (OR 0.2).<h4>Conclusions</h4>There are significant positive and negative determinants of relationship influence related to PrEP at individual-, dyad-, relationship-, and network-levels. These support using nuanced network approaches to behavior change that respect and leverage the diversity of relationships that comprise the social networks of women who have experienced incarceration.
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spelling doaj-art-54f2c7eebd274495b6cbed3605804bb62025-08-20T02:41:42ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011910e031258410.1371/journal.pone.0312584Network determinants of relationship influence on HIV prevention decision-making among people in the social networks of women who have experienced incarceration in the US.Andrea K KnittelGabriel VarelaElla G FergusonHannah HulshultJamie B JacksonJames MoodyAdaora A Adimora<h4>Background</h4>Many cisgender women in the US who have experienced incarceration are at substantial risk for HIV acquisition after they return to the community. Various network interventions have been leveraged for HIV prevention in this population. The objective of this study was to identify network and relationship determinants of influence on HIV prevention decisions, including PrEP.<h4>Methods</h4>We conducted interviews with a network mapping exercise with participants recruited from the social and sexual networks of women who had experienced incarceration. Participants enumerated important individuals in their lives from the past six months and provided demographic and relationship data as well as whether each relationship influenced their HIV prevention decisions. We abstracted network data from the interview transcripts and described the data set using descriptive statistics and network density graphs. To measure associations between characteristics at each level and whether a relationship was considered influential regarding PrEP decision-making, we use multiple logistic regression with random intercepts for each respondent.<h4>Results</h4>We interviewed 32 participants, average age 33.5 years (SD = 8.98), majority female (n = 28, 87.5%), white (n = 23, 71.8%), heterosexual/straight (n = 25, 78.1%), and with a personal history of incarceration (n = 29, 90%). They reported 253 relationships (119 family, 116 friend, 18 sexual relationships). Most adult network members had used drugs or alcohol (n = 182, 80.9%), and of those, 30.8% had used them with the participant (n = 53). The mean network size was 7 (SD = 4) and network density was 52.2%. In the full model, significant positive predictors of an influential relationship included participant non-heterosexual identity (OR 27.8), older average age in the network (OR 3.9 per standard deviation), and being a current or prior sexual partner (OR 10.1). Significant negative predictors included relationships with individuals who use or had used drugs (OR 0.28), longer average relationship duration in the network (OR 0.09) and being in a network with at least one sexual partner (OR 0.2).<h4>Conclusions</h4>There are significant positive and negative determinants of relationship influence related to PrEP at individual-, dyad-, relationship-, and network-levels. These support using nuanced network approaches to behavior change that respect and leverage the diversity of relationships that comprise the social networks of women who have experienced incarceration.https://doi.org/10.1371/journal.pone.0312584
spellingShingle Andrea K Knittel
Gabriel Varela
Ella G Ferguson
Hannah Hulshult
Jamie B Jackson
James Moody
Adaora A Adimora
Network determinants of relationship influence on HIV prevention decision-making among people in the social networks of women who have experienced incarceration in the US.
PLoS ONE
title Network determinants of relationship influence on HIV prevention decision-making among people in the social networks of women who have experienced incarceration in the US.
title_full Network determinants of relationship influence on HIV prevention decision-making among people in the social networks of women who have experienced incarceration in the US.
title_fullStr Network determinants of relationship influence on HIV prevention decision-making among people in the social networks of women who have experienced incarceration in the US.
title_full_unstemmed Network determinants of relationship influence on HIV prevention decision-making among people in the social networks of women who have experienced incarceration in the US.
title_short Network determinants of relationship influence on HIV prevention decision-making among people in the social networks of women who have experienced incarceration in the US.
title_sort network determinants of relationship influence on hiv prevention decision making among people in the social networks of women who have experienced incarceration in the us
url https://doi.org/10.1371/journal.pone.0312584
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