Social networks and stigma: The experiences of African immigrants living with HIV in the United States

Over the past two decades, research on the conceptualization, measurement, and refinement of stigma has grown extensively due to increasing recognition of stigma as a driver of adverse health outcomes. While these lines of research have generally recognized that stigma is enacted in social relationships, few analysts have characterized how the structure and composition of these relationships influence stigma, particularly among immigrant populations. In response, this paper integrates data from social network analysis and in-depth interviews to explore the experiences of and responses to stigma by African immigrants living with HIV in the United States.

All participants reported that they anticipated, experienced, and internalized stigma within their personal networks. Many concealed their status and disclosed to only trusted associates, family members, and medical providers. Building on findings from previous studies, we found that the meanings and belief systems (particularly African cultural discourses that link HIV with mortality, immorality, retribution, and silence) matter for how stigma is assigned, enacted, experienced, and resisted. Our analyses also revealed that the structure of participants personal networks (i.e, the extent to which their associates were connected to each other, and how integrated/involved they were in these network relationships) intensified or diluted their exposure to stigmatizing discourses, depending on the composition (resourcefulness/quality) of their personal networks. Such network connections (i.e., social capital) translate into rewards if they are supportive and accepting, and costs if they stigmatize.

By showing how individuals can use their social networks to stigmatize or support their peers, this study advances theoretical expositions on (1) how the meanings and belief systems held by individuals matter for understanding social network/structural processes, (2) how social networks shape how stigma is assigned, enacted, experienced and resisted,(3) the costs and downsides of social capital, which are often neglected through emphasis on its salutary impacts. Our findings underscore the need for interventions that leverage the salient properties of personal networks to understand, conceptualize, measure, and reduce stigma.