Egocentric Networks and HIV in Pregnant and Breastfeeding Women Attending Antenatal Care in Lusaka, Zambia

Abstract

Kellie Freeborn, Maria C Ramos, Dana K Pasquale, Rose Lungu, Benjamin H Chi, Oliver Mweemba

Human immunodeficiency virus (HIV) has a disproportionate effect on pregnant and breastfeeding women in sub-Saharan Africa. This study used egocentric social network analysis (SNA) to compare the social and sexual networks of HIV-negative and HIV-positive women attending an antenatal care (ANC) clinic in Lusaka, Zambia. In order to assess risk and protective factors for HIV acquisition and transmission, variables included self (ego) sociodemographic characteristics, main partner characteristics, features of the relationship between ego and her main partner, alter attributes, alter-ego ties, and alter-alter ties. Associations between the independent variables and ego HIV status were identified using bivariate tests. Logistic regression analyses were performed to assess the relationship between predictors and ego HIV status when multiple variables were included in the same model. Overall, 219 participating women (69 HIV-positive, 150 HIV-negative) nominated 1095 alters. Compared to HIV-negative egos, HIV-positive egos were older, had main partners who were more likely to consume alcohol before sex, disclosed their HIV status to fewer alters, had fewer alters with whom they had daily interactions, and had more alters who were HIV-positive or HIV-unknown. Number of alters who were HIV-positive or HIV-unknown and non-disclosure of HIV status were the greatest risks (with the effect of HIV-positive or HIV-unknown being of a slightly greater magnitude than non-disclosure of HIV status), which places breastfeeding women, their partners and their infants at risk of preventable HIV infection.

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