Elaine Marieb College of Nursing, University of Massachusetts, Amherst, USA.
Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA.
Afr J AIDS Res. 2024 Oct;23(1-2):21-29. doi: 10.2989/16085906.2024.2337763. Epub 2024 Oct 14.
Adherence to antiretroviral therapy (ART) is crucial for preventing vertical transmission of HIV and maternal deaths. While the literature is replete with studies on ART adherence, the role of social capital in adherence to ART is less studied. Drawing from the social cognitive theory, this study examines the relationship between social capital and post-partum adherence to ART.
We analysed data from 481 post-partum women with HIV in the Eastern Cape, South Africa. Adherence to ART was measured using a validated scale, capturing self-reported medication-taking behaviours. Social capital was assessed using a pre-validated tool, encompassing indicators of social engagement, support networks and community connectedness. We used logistic regression models to examine social capital and ART adherence associations, while controlling for relevant covariates.
Participants mean age was 32.9 (SD ± 5.76) years. After adjusting for age, education level, alcohol use, status disclosure to partner, marital status, desire for more children, employment status and living arrangements, social capital was significantly associated with higher odds of ART adherence (p = 0.004, AOR 1.09; 95% CI 1.03-1.16).
We found evidence in support of the role of social capital in ART adherence. Strengthening social support networks and addressing psychosocial factors could improve adherence to ART. As such, policymakers and programme managers should consider the role of social capital in designing interventions to improve ART adherence. Future research should explore the mechanisms through which social capital impacts ART adherence.
抗逆转录病毒疗法（ART）的依从性对于预防艾滋病毒的垂直传播和孕产妇死亡至关重要。尽管文献中充斥着关于 ART 依从性的研究，但社会资本在 ART 依从性中的作用研究较少。本研究从社会认知理论出发，探讨了社会资本与产后 ART 依从性之间的关系。
我们分析了南非东开普省 481 名 HIV 产后妇女的数据。采用经过验证的量表来衡量 ART 的依从性，该量表捕捉了自我报告的用药行为。社会资本使用经过预验证的工具进行评估，该工具包括社会参与度、支持网络和社区联系的指标。我们使用逻辑回归模型来检验社会资本与 ART 依从性之间的关联，同时控制了相关协变量。
参与者的平均年龄为 32.9 岁（SD ± 5.76）。在调整了年龄、教育程度、饮酒情况、伴侣知晓状况、婚姻状况、生育愿望、就业状况和生活安排后，社会资本与更高的 ART 依从性几率显著相关（p=0.004，AOR 1.09；95%CI 1.03-1.16）。
我们有证据支持社会资本在 ART 依从性中的作用。加强社会支持网络和解决心理社会因素可以提高 ART 依从性。因此，政策制定者和项目管理人员应考虑社会资本在设计干预措施以提高 ART 依从性中的作用。未来的研究应探讨社会资本影响 ART 依从性的机制。
