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. 2025 Apr;29(4):1281-1293.
doi: 10.1007/s10461-024-04602-w. Epub 2024 Dec 30.

Role of Individual and Network Factors in HIV Care Continuum Outcomes among PLWH: An Egocentric Network Study in Yunnan, China

Wenjun Yan #  1 , Di Xu #  2 , Qiongli Duan  3 , Nengmei Huang  3 , Jing Han  1 , Yuhua Shi #  4 , Jian Li #  5 , Hongjie Liu  6
Affiliations

Role of Individual and Network Factors in HIV Care Continuum Outcomes among PLWH: An Egocentric Network Study in Yunnan, China

Wenjun Yan et al. AIDS Behav. 2025 Apr.

Abstract

Due to limited data on the determinants of HIV care continuum outcomes among people living with HIV (PLWH) in resource-limited settings, this study aimed to identify individual and social support network factors influencing these outcomes, thereby informing the development of intervention strategies to achieve the UNAIDS 95-95-95 targets. PLWH in Yunnan, China, were recruited using convenience sampling at three stages of the HIV care continuum: linkage to care, antiretroviral therapy (ART) initiation, and viral suppression. An egocentric network design combined with multilevel logit modeling was employed to investigate factors associated with ART initiation and viral suppression. A total of 410 eligible participants were recruited into the study. Of these, 145 (35.4%) were linked to care but did not initiate ART, 265 (64.6%) initiated ART, and 131 (49.4%) achieved viral suppression. Higher trust in alters, larger network density, stronger social support, and longer ego-alter relationship were positively associated with ART initiation and viral suppression. Participants who received social support from friends or family members had higher odds of initiating ART compared to those who received support from sexual partners. Factors associated with viral suppression were larger network size, having older alters and alters with higher education in an ego's social support network. The findings enhance our understanding of how social support network determinants influence HIV care continuum outcomes. Interventions for PLWH in China should consider these social support network characteristics to improve outcomes.

Keywords: ART Initiation; China; People Living with HIV; Social Support Network; Viral Suppression.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that there is no potential conflict of interest. Ethics Approval: The study protocol was approved by the Ethics Committee of the National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention (Ethics Approval Number: KX180801518). Informed Consent: Informed consent was obtained from all individual participants included in the study. Disclaimer: The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position of the funding agencies.

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