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

Increasing recognition of stigma as a driver of adverse health outcomes has spurred extensive research on the conceptualization, measurement, and refinement of stigma. Even though 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, we integrated 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 it to trusted associates, family members, and medical providers. Building on previous studies, we found that meanings and belief systems (particularly African cultural discourses that link HIV with mortality, immorality, retribution, and silence) matter for how stigma is assigned, enforced, and experienced. Our analyses also revealed that the structure of participants’ personal networks intensified or diluted their exposure to stigmatizing discourses, depending on the composition (i.e., extent of accurate HIV knowledge, similarity/homophily) of these 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 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. • Among African immigrants’ HIV stigma is shaped by distinct cultural discourses • Study integrates social network analyses and in-depth interviews • Social networks shape how stigma is anticipated, experienced, internalized, resisted • Social network mechanisms and interpersonal contact be leveraged to address stigma • Stigma interventions must address knowledge deficits, promote accepting attitudes