The Role of Health Networks in Disseminating Knowledge about Infant HIV Testing in Rural Uganda: Population-Based Sociocentric Network Study

Early testing of infants exposed to HIV can significantly decrease mortality for those linked to HIV treatment. Infants exposed to HIV should first be tested at 6 weeks of age, but only 60% are tested as recommended. Little research has focused on the role of social networks in disseminating information about infant HIV testing. We conducted a cross-sectional, sociocentric network study of all adults living in a rural parish in Uganda (N=1,383) and gathered data on socio-demographic characteristics, self-reported HIV status, and knowledge about infant testing recommendations. We administered a culturally-adapted name generator to measure the parish health network. We fitted a multivariable generalized linear regression model with a logit distribution to estimate the association between having at least one social tie with correct knowledge about early infant testing and individual knowledge about infant testing. Having at least one social tie who knew about infant HIV testing at 6 weeks was positively associated with correct knowledge about early infant testing (adjusted odds ratio [aOR] 1.42, 95% confidence interval [CI] 1.07- 1.88, p-value=0.02). Correct knowledge about early infant testing was also associated with having daily contact with social ties (aOR 1.31, 95% CI 1.00-1.71, p-value=0.05) and being considered an authority for health advice within the network (aOR 1.81, 95% CI 1.18-2.77, p-value=0.01). These findings suggest that interventions to enhance peer-to-peer information exchange could increase knowledge about early infant testing, since individuals rely on close, frequently contacted social ties. Network-central individuals can also be engaged to disseminate information about early infant testing.