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PubMed2004

Disclosure of HIV-positive status to Latino gay men's social networks.

This study explored disclosure of serostatus in a sample of 155 HIV-positive Latino gay men from New York City and Washington, DC. We examined rates of disclosure to different members of the social network: mothers, fathers, close friends, and primary sexual partners. There were high rates of disclosure of HIV-positive serostatus to main partners and closest friends and lower rates to fathers and mothers. We examined the role of 3 contextual target-dependent factors (emotional closeness to target, anticipated reactions from target, and target's knowledge of sexual orientation), as well as acculturation and time since diagnosis. Three separate logistic regression models were performed to predict disclosure of HIV-positive status to 3 targets: mothers, fathers, and closest friends. We found that disclosure was not a generalized tendency, but rather different factors were influential depending on the target. Whether the target was aware of participant's sexual orientation was associated with disclosure in all 3 models. Greater emotional closeness also predicted disclosure to mother and father; greater U.S. acculturation was associated with disclosure to father and marginally to mother. A longer time since diagnosis was associated with disclosure to the closest friend. These findings highlight the importance of taking into account roles and relationships, and their effect on disclosure.

Adolescent↗
PubMed1987

Social network characteristics and psychological well-being: a replication and extension.

This article represents a replication and extension of a previous study by Israel and her colleagues that investigated the relationship between psychological well-being and social network characteristics. The present research included both a comparable sample of white women (N = 104) between the ages of 60 and 68 (as in the original study), and a more extensive adult population of men and women (N = 718) between the ages of 50 and 95. The network characteristics examined are categorized along three broad dimensions: Structure--linkages in the overall network (size and density); interaction--nature of the linkages themselves (frequency, geographic dispersion, and reciprocity); and functions that networks provide (affective support and instrumental support). The results indicate a predominance of comparable findings for both the replication and extension studies. Of the eight network characteristics examined, the results of five of the regression analyses were the same across all three studies. The network characteristics of size, density, geographic dispersion, reciprocal instrumental support, and instrumental support did not make a significant contribution to the variance in psychological well-being. Of the other three network characteristics, the effect of frequency of interaction varied across the studies, and a pattern of significant results was found for affective support and reciprocal affective support. A discussion of this evidence in light of current literature and implications for practice and research is included.

Aged↗
PubMed2005

Use of social networks to identify persons with undiagnosed HIV infection--seven U.S. cities, October 2003-September 2004.

An estimated 250,000 persons living with human immunodeficiency virus (HIV) in the United States are not aware of their infections and their risk for transmitting HIV. As part of CDC's Advancing HIV Prevention Initiative, identifying persons with undiagnosed HIV infection and linking them to medical care and prevention services is a national priority. In 2003, a 2-year demonstration project was begun with nine community-based organizations (CBOs) in seven cities to evaluate the effectiveness of using a social network strategy at multiple sites to identify persons at risk for HIV infection and direct them to HIV counseling, testing, and referral (CTR). In this strategy, HIV-positive persons and HIV-negative persons at high risk (i.e., recruiters) are enlisted to recruit for CTR persons from their social, sexual, and drug-use networks (i.e., network associates [NAs]) believed to be at risk for HIV infection. This report summarizes preliminary results from the first year of this 2-year project, which indicated that 133 persons recruited 814 NAs, resulting in 46 newly identified HIV infections (approximately 6% of all persons tested). Health departments and CBOs should consider this strategy as an effective method for recruiting persons for CTR and identifying those with undiagnosed HIV infection.

AIDS Serodiagnosis↗
PubMed2003

Norms, social networks, and HIV-related risk behaviors among urban disadvantaged drug users.

Altering norms may be an important approach to introducing and sustaining health protective behavior change. This study sought to examine the relationship between condom use, condom norms, and social network characteristics among a sample of economically impoverished individuals at risk for acquiring and transmitting HIV. Participants were 1051 individuals from a drug-using community in the USA. Eighty percent were current drug users; 17% were HIV seropositive. Reported condom use was strongly associated with peer norms about condom use (friends talking about condoms, encouraging condom use, and using condoms). Women were less likely than men to report that their friends used condoms. Injection drug use was negatively associated with peer norms about condom use, while church attendance and network characteristics were positively associated with condom-promoting norms. The size of the health advice and the financial support networks was most positively related to condom norms. Network methodology may aid in the identification of specific ties that promote condom use norms in a population. The findings of this study may have implications for norm change interventions among disadvantaged communities at high risk for HIV/AIDS.

Adolescent↗
PubMed2006

Links between social network closure and child well-being: the organizing role of friendship context.

Third grade children (N = 404) and their mothers completed questionnaires and participated in interviews designed to identify children's friendships across multiple contexts, determine levels of social network closure for these friendships, and assess child well-being. Cluster analyses revealed distinct patterns in the contexts in which children's friendships were maintained. Closure was highest for children whose friendship clusters heavily represented relatives as friends and lowest when friends were from schools and the broader community. Intermediate levels of closure were observed for the clusters of neighborhood friends and friends from church and school. Both friendship cluster and, to some extent, ethnicity moderated associations between closure and indicators of well-being.

Child↗
PubMed1988

[The appropriate social network: an operative instrument for the evaluation of indications for psychiatric hospitalization].

The role of hospitalization in the treatment of mental disease is reviewed. In support of this paper, contributions emphasizing the role society plays in causality and reparative techniques as well are referred to. Conservation or deterioration of a patient's own social network--both primary and secondary groups--is suggested as an observable parameter in clinical practice. The extent of deterioration may suitably clarify whether hospitalization is advisable. The authors envision hospitalization as an essential means because the patient is given an artificial or substitute network--his or here reinsertion wherein being stimulated accordingly--at the same time the natural network is being restored.

Hospitalization↗
PubMed2003

[Test-retest reliability of measures of social network in the "Pró -Saúde" Study].

OBJECTIVE: To evaluate test-retest reliability of social network-related information of the" Pr -Sa de" study. METHODS: A test-retest reliability study was conducted using a multidimensional questionnaire applied to a cohort of university employees. The same questionnaire was filled out twice by 192 non-permanent employees with two weeks apart. Agreement was estimated using kappa statistics (categorical variables), weighted kappa statistics, log-linear models (ordinal variables), and intraclass correlation coefficient (discrete variables). RESULTS: Estimates of reliability were higher than 0.70 for most variables. Stratified analyses revealed no consistently varying patterns of reliability according to gender, age or schooling strata. Log-linear modelling showed that, for the study ordinal variables, the model of best fit was "diagonal agreement plus linear by linear association". CONCLUSIONS: The high level of reliability estimated in this study suggests that the process of measurement of social network-related aspects was adequate. Validation studies, which are currently being conducted, will complete the quality assessment of this information.

Adult↗
PubMed1997

"We decide, you carry it out": a social network analysis of multidisciplinary long-term care teams.

The purpose of this study was to describe the structure of multidisciplinary long-term care teams by identifying the pattern of relationships that develop amongst staff as they go about their work. Using a social network analysis approach, team members were classified as occupying the same structural position based on their patterns of relationships with other team members. The analysis was based on the results of a self-administered survey of 93 health care workers on three teams in the same multilevel geriatric care facility in Metropolitan Toronto. A common structure of the teams was identified consisting of two sub-teams: a multiprofessional sub-team and a nursing sub-team, each of which has a different structure indicating differential involvement in different types of teamwork. The multiprofessional sub-team has an "organic" structure and is mainly involved in teamwork that involves decision-making and problem-solving, whereas the nursing sub-team has a "mechanistic" structure and is mainly involved in task oriented work. The findings of this analysis indicate that while teamwork may be increasing the participation in decision-making by health professionals other than medicine, rather than flattening the hierarchical structure throughout the health care division of labour, its effects are limited to a group of higher status professionals. The clearly defined hierarchy remains for the lower status subdisciplines, and "I decide, you carry it out" has simply become "We decide, you carry it out".

Adult↗
PubMed1988

Social networks and the functional health status of the poor: a secondary analysis of data from the National Survey of Personal Health Practices and Consequences.

This study uses data from the Wave I of the National Survey of Personal Health Practices and Consequences (N = 3025) to examine the relationship between social networks and the health status of the poor. No single category of networks was found to be consistently predictive of health status among the poor. The number of close friends, satisfaction with number of close ties, frequency of contact with network ties and church attendance were all significantly related to health status, but in no case were sufficient to bring health status levels of the poor up to the level of the nonpoor.

Adult↗
PubMedDate not supplied

New mother groups as a social network intervention: consumer and maternal and child health nurse perspectives.

Maternal and child health nurses in two outer urban local government areas in Melbourne, Australia were interviewed about how they facilitated first-time parent groups. Groups were offered to all first time mothers and almost two thirds of mothers joined a group. The groups ran for approximately eight sessions and provided infant-focussed parent education and social contact. Women who joined the groups were followed up 18 months to two years later to determine the degree to which these groups continued to meet on their own accord and the extent to which they had become self-sustaining social networks. The study found a very high level of continuation, suggesting that providing such programs may be an important vehicle for enhancing social support during the transition to parenthood and thus be a useful primary prevention strategy.

Adult↗
PubMed2006

Use of social network analysis to characterize the pattern of animal movements in the initial phases of the 2001 foot and mouth disease (FMD) epidemic in the UK.

Aggregated movement data do not take into account the relative position of the units within a higher-level structure. Social network analysis (SNA) and graph theory provide a tool to organise and analyse relational data overcoming the limitations of standard methods where the position of individuals/observations does not affect the result of the analysis. Some recorded movements of cattle and sheep during the initial phase of the 2001 foot and mouth disease (FMD) outbreak in the UK, before the ban on animal movements was imposed, are analysed descriptively using SNA. With the data available, a directed dichotomized network with 653 nodes and 797 arches was analysed. Most of the 10 nodes with the highest betweenness (3 farms, 4 markets and 3 dealers) were identified as key players in the initial spread of the infection. Three groups of nodes with distinctive proportion of k < or = 2 neighbours would result in three different theoretical outbreak dimensions assuming that the infection is only disseminated by the movements included in the network: no spread, spread up to 7% and around 25%. There are three hierarchical clusters with 308, 215 and 130 nodes, respectively. Farms in cluster 1 appear to be more similar in their movement patterns to non-farm holdings than to farms in clusters 2 and 3. Relative betweenness, k-neighbours and structural equivalence using hierarchical clustering were able to identify key actors in the evolution of the initial phases of the FMD outbreak such as markets, dealers and farms with atypical movement patterns. Holdings with high betweenness, large number of k < or = 2 neighbours and with movement pattern as in cluster 1 should be targeted in disease control activities once primary actors like markets, dealers and slaughter houses have been contained.

Animals↗
PubMed2002

Risking risk: the influence of types of capital and social networks on the injection practices of drug users.

Although syringe exchange and other harm reduction interventions have generally been effective in reducing bloodborne pathogen incidence among injection drug users (IDUs), in some cases a minority of IDUs continues to engage in risky injection behavior. Building on emerging perspectives in social epidemiology and research on drug use in anthropology that point to the importance of examining fundamental social causes of risk behavior, or what puts individuals at risk for risk, this study used a multilevel perspective to explore whether forms of capital, social network characteristics, and other contextual factors influence continued risky injection behavior. Quantitative and qualitative data were collected on IDUs in the city of Marseilles, France, where sterile injection equipment has been legal and officially promoted since 1995. In multivariate analysis on data concerning active users, location in the densest part of a large, interconnected network of IDUs greatly increased the likelihood of risky injection practices, while there was a non-significant tendency for low Acquired Cultural and Economic Capital to predict this behavior. Among the strongest individual-level characteristics to predict this outcome were illicit use of prescribed medication, generally high dose buprenorphine, and unprotected sex. Parental abuse of psychoactive drugs during the subject's childhood, on the other hand, greatly decreased the chances of engaging in risky injection behavior. Additionally, qualitative data analysis suggests that risky injection may be linked to lack of resources to procure drugs, and not simply to inadequate sterile injection equipment. Further research, including ecological models, is needed to better understand how fundamental social conditions are related to "risk for risk". However, public health interventions can already address the need for community-level interventions, while rethinking the consequences of inaccessible drugs and unintended "leakage" from the introduction of buprenorphine and other medicalized treatments for opiate dependency.

Adult↗
PubMed1991

Social support and social networks: their relationship to the successful and unsuccessful survival of elderly people in the community. An analysis of concepts and a review of the evidence.

Many studies suggest that there is a relationship between social support and physical and psychological health status, risk of institutionalization and mortality of the elderly. Although longitudinal analyses confirm these suggestions, all studies experience problems with network methodology, and none use comparable operational or working definitions. It is known that there is an effect between these variables, but the nature of the relationship is still unknown. This paper reviews existing research on social networks, social support and associations with health status, mortality and risk of institutionalization.

Aged↗
PubMed1997

Living situation, social network and outcome in schizophrenia: a five-year prospective follow-up study.

A representative sample of 227 first-contact schizophrenic patients (according to DSM-III) was followed up for 5 years. The psychiatric teams responsible for the treatment of the patients conducted detailed standardized interviews with the patients at entry and at the end of the first, second and fifth years. Changes in patients' clinical and functional outcome were analysed according to their living situation and social network. Positive changes in clinical state and functional ability were most prominent among patients who were living with their spouse. The social and functional outcome of men living with their parents was better than that of women in the same situation, while among patients living alone or with some other person the gender difference was reversed. Family environment can be of great importance to schizophrenic patients, supporting their clinical and functional recovery from psychosis. Patients living outside families--and men in particular--are at great risk of poor outcome, perhaps because they often lose their social contacts. In the treatment of such individuals a more active strategy of out-patient and rehabilitative care is therefore needed.

Adolescent↗
PubMed2000

Peer promotion programs and social networks in Ghana: methods for monitoring and evaluating AIDS prevention and reproductive health programs among adolescents and young adults.

This article summarizes the observations and lessons learned regarding the application of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) prevention and reproductive health evaluation methodologies in the context of adolescent and young adult populations and discusses the use of peer network evaluation to understand the dynamics of peer promotion. To examine the interpersonal communication process of peer education, this study tested a new approach using multiple semistructured interviews and network analysis to collect data on 106 peer educators and 526 of their contacts. These evaluation activities were conducted at three sites in Ghana during April 1998, in both periurban and rural locations in both in-school and out-of-school settings. By evaluating the social networks of peer educators it was possible to gain a better understanding of the process of peer education in terms of (a) defining the composition of peer contacts, (b) identifying the social norms that play a critical role in youth decision making, and (c) observing the range of messages and services transmitted during peer education. The objective of this paper is to disseminate the experience of the Center for Education and Development of Population Activities (CEDPA) and Focus on Young Adult's cooperative development of evaluation methodologies for peer promotion and to highlight utilization of these methodologies in a case study in Ghana. The results will be discussed in terms of their possible implications for program managers, researchers, and international agencies.

Acquired Immunodeficiency Syndrome↗
PubMed1994

AIDS, HIV infection, and illicit drug use within inner-city families and social networks.

OBJECTIVES: Drug use is commonly depicted and treated as an individual problem. This study describes the extent of drug use, human immunodeficiency virus (HIV) infection, and acquired immunodeficiency syndrome (AIDS) among drug users' sexual partners and family and household members in order to broaden considerations of risk. METHODS: Social network charts and structured interviews were administered to 126 women (predominantly African American and Latino) enrolled in methadone treatment. The charts elicited the prevalence of drug use and HIV infection among subjects' family and household members. RESULTS: Drug use and HIV/AIDS permeated subjects' sexual, familial, and household relationships. More than half of the women who resided with a sexual partner reported that their partners currently used drugs. Almost one third of the subjects' siblings were drug users. Of the 715 total siblings (all subjects plus their siblings), 69 (9.7%) were known to be HIV positive or to have an AIDS diagnosis. CONCLUSIONS: The sexual, familial, and household expressions of drug use underscore the notion that drug use and attendant risks, including but not limited to HIV infection, might be usefully viewed and treated as an inter- and intracommunity problem rather than as an exclusively individual one.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Syringe exchange not associated with social network formation: results from Baltimore.

OBJECTIVE: To examine possible formation of new social contacts at the Baltimore Syringe Exchange Program (SEP). DESIGN: Systematic sub-sample of new SEP participants recruited into evaluation cohort for biannual interviews. This analysis used 6-month interview data. METHODS: Participants were interviewed for behavioral and network characteristics, and number of new social contacts formed at the SEP. Variables were cross-tabulated using chi2 statistics. RESULTS: Of 413 participants interviewed, 32 (8%) said they had made at least one social contact at the SEP. These 32 individuals were more likely to have engaged in commercial sex (16 versus 3%, P = 0.005) and, among active injectors, were more likely to have used syringes obtained from other drug users (22 versus 8%, P = 0.026). CONCLUSIONS: Findings argue against the formation of new social networks (and therefore new disease transmission networks) in the context of syringe exchange participation.

Adult↗