# Using network analysis to elucidate the relationships among support systems, trauma and depressive symptoms, self-silencing, and risk of HIV viral non-suppression among black women living with HIV

## TL;DR

This study explores how support systems and psychological factors like trauma and self-silencing affect HIV viral suppression in Black women living with HIV.

## Contribution

The study introduces a network analysis approach to understand the interplay between support systems and HIV risk factors in Black women.

## Key findings

- Friend support showed a weak to moderate correlation with HIV risk scores.
- PTSD and depressive symptoms correlated weakly with risk through self-silencing.
- Care as self-sacrifice strongly correlated with HIV risk scores.

## Abstract

Human immunodeficiency virus (HIV) remains a major public health issue in the United States (US) and Black women living with HIV (BWLWH) are disproportionately impacted among women. This study investigates the complexities in influences of family, friend, and special person support systems and their association with post-traumatic stress disorder symptoms (PTSD), depressive symptoms, gendered coping (self-silencing), and a composite HIV risk score related to risk of viral non-suppression through missed medical visits, low medication adherence, and high viral load. Cross-sectional data among BWLWH were analyzed using network analyses via RStudio. Data from 119 BWLWH was reduced to 104, because of missing data on indicators as well as pairwise deletion for the correlation function. Findings revealed variances based on the type of network. For composite risk scores, friend support source had a weak to moderate significant correlation, while symptoms of PTSD and depression only showed a weak positive correlation with the composite risk variable through self-silencing as a form of coping. The post-hoc analysis showed a strong correlation with care as self-sacrifice, based on the composite risk score. Based on the findings from this study, insight was given into symptoms for depression and PTSD, as well as self-silencing and viral non-suppression risk in relation to sources of support for BWLWH. Future interventions to improve the overall health of BWLWH may benefit from incorporating support from friends and lowering care as self-sacrifice.