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

Obatsa, Sarah; Mburia-Mwalili, Adel; JaureguiIII, Salvador; D. Wagner, Karla; Atwoli, Lukoye; Odhiambo, Francesca; Lewis-Kulzer, Jayne; Goodrich, Suzanne; Wools-Kaloustian, Kara; L. Syvertsen, Jennifer

dc.contributor.author	Obatsa, Sarah
dc.contributor.author	Mburia-Mwalili, Adel
dc.contributor.author	JaureguiIII, Salvador
dc.contributor.author	D. Wagner, Karla
dc.contributor.author	Atwoli, Lukoye
dc.contributor.author	Odhiambo, Francesca
dc.contributor.author	Lewis-Kulzer, Jayne
dc.contributor.author	Goodrich, Suzanne
dc.contributor.author	Wools-Kaloustian, Kara
dc.contributor.author	L. Syvertsen, Jennifer
dc.date.accessioned	2026-08-06T07:01:28Z
dc.date.available	2026-08-06T07:01:28Z
dc.date.issued	2026-06-24
dc.identifier.uri	https://doi.org/10.1371/journal.pgph.0006273
dc.identifier.uri	http://ir.mu.ac.ke:8080/jspui/handle/123456789/10430
dc.description.sponsorship	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 net- works 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 identify- ing 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 num- ber 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.	en_US
dc.language.iso	en	en_US
dc.publisher	PLOS GLOBAL PUBLIC HEALTH	en_US
dc.subject	Mental health	en_US
dc.subject	Stigma	en_US
dc.subject	HIV	en_US
dc.title	Social relationships, mental health, and stigma: A qualitative study of social networks and HIV disclosure in Western Kenya	en_US
dc.type	Article	en_US