Social support for people living with HIV in rural America remains a considerably understudied aspect of HIV/AIDS prevention. People living with HIV/AIDS (PLHA) require extensive support in order to remain in care, and reduce their viral suppression, and other disease complications. Without support, the likelihood that PLHA will refrain from or drop out of treatment options is gravely heightened, which consequently poses a significant threat for efforts to eliminate HIV as a public health issue. Using a mixed-method approach to Social Network Analysis, this study examines the principal role that social support plays in a person’s likelihood to adhere to care and consequently, attain viral suppression. Specifically, it looks at the roles of the family, friends, partners/spouses, and healthcare providers. The study also explores how social relations serve as mediators to stigma and discrimination, especially for disproportionate groups. Closely linked to social support availability is the perceived level of significance of the type of support that is available to the subjects. The study therefore goes further to explore the subjects’ perception of the support they receive (emotional, informational, and instrumental) and their satisfaction with it. This is imperative in that it sheds light on the role that the subjects’ social relations plays in their retention in care. This research again takes an interdisciplinary approach by exploring the contribution of both communication and health communication strategies to effect behavioral change. It contributes to research on HIV/AIDS health equity, and infectious disease management. It also contributes to efforts to identify strategies to control the spread of HIV by proposing efficient ways to optimize social support through the stages of the Care Continuum and consequently, facilitate an increase in the number of people who attain viral suppression. Keywords: Social Network Analysis; Social Support; Rural HIV; PLHA; Stigma.

High levels of HIV stigma are reported for people living with HIV or AIDS (PLHA) and PLHA have to cope with this. These experiences may differ in a rural and urban setting. Obtaining a true reflection of the level of HIV stigma experienced by PLHA in a rural and urban setting and their level of coping self-efficacy, while dealing with this stigma, will be helpful in planning future intervention strategies. The study aims to compare qualitative expressed experiences with quantitative measures of levels of HIV stigma and coping self-efficacy of PLHA in a rural and urban setting. Secondly the aim is to establish the relationship between the levels of HIV stigma experiences of PLHA and coping self-efficacy of PLHA. The study took place in the North West Province, in both a rural (n=12) and urban (n=11) setting. Participants were selected by means of purposive sampling. A convergent parallel design was used within a mixed method approach. In-depth interviews provided qualitative data. Quantitative data came from two scales, the HIV and AIDS stigma scale-PLWA (HASI-P) (Holzemer et al., 2007a) and the Coping self-efficacy scale (CSE) (Chesney, Neilands, Chambers, Taylor, & Folkman, 2006). The study revealed that HIV stigma does exist, and is experienced by PLHA in the North West province in both a rural and an urban setting with no significant difference. Qualitative data confirmed the results of the HIV stigma measure, and also provided a rich understanding of the differences in contexts between the two settings. Additional types of stigma found to those included in the HASI-P point to shifts in the way people and communities experience HIV stigma. Results of the CSE scale showed that PLHA from both rural and urban settings employed the three types of coping self-efficacy as described by Chesney et al. (2006), with no significant difference between the two groups. Statistical correlations within the HASI-P revealed correlations between certain types of stigma experienced, indicating that HIV stigma is not experienced in a single dimension but can extend to more than one area of the lives of PLHA. Correlations within the CSE scale illustrate that ways PLHA cope may be related to each other Recommendations focus on further research options, policy development and implementation in practice. The goals of the research were reached in that it was confirmed that HIV stigma and coping self-efficacy of PLHA in rural and urban settings, using qualitative and quantitative methods, does exist. The relationship between HIV stigma and coping self-efficacy of PLHA was established through the correlation of scales and through the evidence found during in-depth interviews; that HIV stigma exists and that PLHA develop coping self-efficacy to deal with it. / Thesis (MA (Research Psychology))--North-West University, Potchefstroom Campus, 2013

High levels of HIV stigma are reported for people living with HIV or AIDS (PLHA) and PLHA have to cope with this. These experiences may differ in a rural and urban setting. Obtaining a true reflection of the level of HIV stigma experienced by PLHA in a rural and urban setting and their level of coping self-efficacy, while dealing with this stigma, will be helpful in planning future intervention strategies. The study aims to compare qualitative expressed experiences with quantitative measures of levels of HIV stigma and coping self-efficacy of PLHA in a rural and urban setting. Secondly the aim is to establish the relationship between the levels of HIV stigma experiences of PLHA and coping self-efficacy of PLHA. The study took place in the North West Province, in both a rural (n=12) and urban (n=11) setting. Participants were selected by means of purposive sampling. A convergent parallel design was used within a mixed method approach. In-depth interviews provided qualitative data. Quantitative data came from two scales, the HIV and AIDS stigma scale-PLWA (HASI-P) (Holzemer et al., 2007a) and the Coping self-efficacy scale (CSE) (Chesney, Neilands, Chambers, Taylor, & Folkman, 2006). The study revealed that HIV stigma does exist, and is experienced by PLHA in the North West province in both a rural and an urban setting with no significant difference. Qualitative data confirmed the results of the HIV stigma measure, and also provided a rich understanding of the differences in contexts between the two settings. Additional types of stigma found to those included in the HASI-P point to shifts in the way people and communities experience HIV stigma. Results of the CSE scale showed that PLHA from both rural and urban settings employed the three types of coping self-efficacy as described by Chesney et al. (2006), with no significant difference between the two groups. Statistical correlations within the HASI-P revealed correlations between certain types of stigma experienced, indicating that HIV stigma is not experienced in a single dimension but can extend to more than one area of the lives of PLHA. Correlations within the CSE scale illustrate that ways PLHA cope may be related to each other Recommendations focus on further research options, policy development and implementation in practice. The goals of the research were reached in that it was confirmed that HIV stigma and coping self-efficacy of PLHA in rural and urban settings, using qualitative and quantitative methods, does exist. The relationship between HIV stigma and coping self-efficacy of PLHA was established through the correlation of scales and through the evidence found during in-depth interviews; that HIV stigma exists and that PLHA develop coping self-efficacy to deal with it. / Thesis (MA (Research Psychology))--North-West University, Potchefstroom Campus, 2013