Social relationships, mental health, and stigma: A qualitative study of social networks and HIV disclosure in Western Kenya

PLOS Global Public Health

卷:6

Research Article

Sarah Obatsa¹  Adel Mburia-Mwalili²  Salvador Jauregui³  Karla D. Wagner²  Lukoye Atwoli^4,5  Francesca Odhiambo¹  Jayne Lewis-Kulzer⁶  Suzanne Goodrich⁷  Kara Wools-Kaloustian⁷  Jennifer L. Syvertsen³ 

[1] Department of Anthropology, University of California, Riverside, California, United States of America

[2] Department of Mental Health and Behavioural Sciences, Moi University School of Medicine, Eldoret, Kenya

[3] Department of Obstetrics, Gynecology & Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, California, United States of America

[4] School of Public Health, University of Nevada, Reno, Nevada, United States of America

[5] Department of Medicine, School of Medicine, Indiana University, Bloomington, Indianapolis, United States of America

[6] Brain and Mind Institute, and Department of Medicine, Medical College East Africa, The Aga Khan University, Karachi, Pakistan

[7] Kenya Medical Research Institute (KEMRI), Kisumu, Kenya

关键词: Mental health and psychiatry;    HIV diagnosis and management;    HIV;    Social networks;    Emotions;    Human families;    Fear;    Kenya;   

DOI  :  10.1371/journal.pgph.0006273

 received in 2026-01-06, accepted in 2026-05-24,  发布年份 2026

来源: PLOS

【 摘 要 】

The disclosure of one’s HIV-positive status is a personal decision that can play an important role in engagement in HIV treatment and care. Social network approaches situate individuals within broader webs of social connections that influence health and wellbeing and thus hold the potential to elucidate key social factors shaping the process of disclosure. As part of a larger clinical study examining how substance use and mental health shape HIV outcomes, we recruited 61 individuals newly diagnosed with HIV at two clinics in Western Kenya to participate in an egocentric social networks study. We conducted a survey that generated a visual network map to guide a subsequent qualitative interview about experiences being diagnosed and living with HIV. We thematically analyzed the qualitative data and visual network maps to examine the social contexts and patterns of HIV disclosure, with the goal of identifying supportive contexts of disclosure. The mean age was 36.7 years (range: 20–62); women were significantly younger than men and more likely to self-report a mental health issue. Typically, participants disclosed their HIV-positive status to a small number of close, trusted alters in their network, including intimate partners, siblings and other family members, and friends. The need for mental health support in the wake of a new diagnosis, especially among women, encouraged disclosure. Across nearly all stories, stigma was a powerful deterrent to sharing one’s status, and multiple people noted prior disclosure to others not named in their current networks because their relationships were negatively impacted. Our study shows how the intersection of social relationships, mental health, and stigma is critical in understanding decision-making processes around disclosure. Selective disclosure typically improved participants’ wellbeing while stigma precluded disclosure and exacerbated distress. Our study offers suggestions for social network interventions to support people living with HIV/AIDS.

【 授权许可】

CC BY   
Obatsa et al 2026

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