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The Impact of Psychosocial, Structural, and Network Factors on Antiretroviral Therapy (ART) Adherence among Black Mothers Living with HIV

Mangum, Laurenia (2023) The Impact of Psychosocial, Structural, and Network Factors on Antiretroviral Therapy (ART) Adherence among Black Mothers Living with HIV. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Maintaining ART adherence and achieving viral suppression among Black mothers living with HIV (BMLWH) is paramount for attaining optimal HIV care outcomes. The goal of this cross-sectional study was to 1) identify key psychosocial and structural factors associated with ART adherence, 2) describe egocentric network characteristics of BMLWH, and 3) examine the associations between network characteristics and ART adherence among BMLWH. Purposive snowball sampling was used to recruit (N = 25) BMLWH in the United States. Participants completed a 30-minute online survey assessing their individual and network characteristics. Descriptive statistics were conducted to describe the sample and their networks. Pearson’s correlation coefficient was conducted to determine the association between psychosocial, structural, and network factors and ART adherence. Independent samples t-tests were conducted to determine group differences in psychosocial and structural factors by ART adherence status. On average, BMLWH were 42 years old (SD = 13.77), single (64%), stably housed (86%), low-income (60%), living with HIV for 15 years (SD = 9.72), and moderately ART adherent (85.36%). Most BMLWH (80%) identified four network members with whom they discussed their HIV status. Networks were moderately dense (0.71) and provided multiple forms of social support. HIV-related resilience was associated with increased ART adherence (r = .46, p < .05). Conversely, parenting worry was associated with reduced ART adherence (r = -.51, p < .01). BMLWH who were sub-optimally adherent had lower HIV-related resilience (M= -8.84, SD = 13.45), higher perceived stressors (M= 49.00, SD = 7.50), and elevated depression (M= 12.75, SD = 5.01). Comfort discussing their HIV status with alters was associated with ART adherence (r= .57, p = .004). Findings revealed that BMLWH were multi-stressed. Solutions to ameliorate suboptimal ART adherence among BMLWH should address multilevel psychosocial and structural barriers impeding HIV treatment and care. In addition, the findings demonstrate the necessity of utilizing network analysis to optimize ART adherence among BMLWH to ameliorate racial, gendered HIV disparities. Implications for social work and future directions are discussed.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Mangum, Laurenialam290@pitt.edulam2900000-0002-8291-6754
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCopeland, Valiresswvcc@pitt.edusswvcc
Committee CoChairWhitfield,
Committee MemberEack, Shaunsme12@pitt.edusme12
Committee MemberChu, Karhaichuk@pitt.educhuk
Committee MemberBlackstock,
Date: 3 January 2023
Date Type: Publication
Defense Date: 20 October 2022
Approval Date: 3 January 2023
Submission Date: 18 November 2022
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 180
Institution: University of Pittsburgh
Schools and Programs: School of Social Work > Social Work
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: antiretroviral therapy, Black mothers, HIV, treatment, viral suppression, treatment adherence
Date Deposited: 03 Jan 2023 14:17
Last Modified: 03 Jan 2023 14:17


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