Harnessing Egocentric Networks to Inform an Enhanced Social Network Strategy in a Southern US "Ending the HIV Epidemic" Region.

BACKGROUND

The HIV epidemic in the United States disproportionately affects sexual and gender minority (SGM) communities. Social networks shape health behaviors. Understanding the structure and dynamics of SGM networks could enhance engagement with HIV-related services.

METHODS

We analyzed egocentric social networks of SGM individuals in Charlotte, North Carolina, who engaged in HIV-related services. Participants (egos) identified social connections (alters) from the past 6 months. Networks were stratified based on the size of the ego's sexual network (0-1 vs. ≥2), defined as the subset of alters with reported sexual partnerships, to assess differences in structure and support dynamics.

RESULTS

Among 51 participants, 294 alters were reported. Networks with 0-1 sexual partners were smaller, more connected, and exhibited greater demographic diversity. These egos had stronger ties with their alters (n = 141), who were more likely to provide social and health-related support. By contrast, networks with ≥2 sexual partners (n = 153 alters) were less cohesive, exhibited lower network density and global efficiency (capacity for efficient information sharing), and sexual partners were less likely to offer health support.

CONCLUSIONS

Network-based interventions must account for pre-existing social support structures. Tight-knit, supportive networks may reinforce health norms and serve as conduits for intervention messaging, while individuals with larger, less connected sexual networks may require additional support to mobilize their networks effectively. Tailoring interventions to network dynamics could enhance HIV service uptake and improve health outcomes in SGM populations.