The Strength of Long Ties for Aging Healthy with HIV: The Case of Rural South Africa

Shao-Tzu Yu, Princeton University
Brian Houle, Australian National University
Francesc Xavier Gomez-Olive, University of the Witwatersrand
Chodziwadziwa Kabudula, University of the Witwatersrand
Nicole Angotti, American University

In lower-income settings, personal social networks are essential channels for older adults to access resources and support. Here we tested the importance of long ties – ties that span greater geographical and network spaces – on HIV treatment dynamics in a rural South African community with a large aging population living with HIV. We analyzed data from the “Health and Aging in Africa: a Longitudinal Study of an INDEPTH community in South Africa” (HAALSI), a panel study of adults aged 40+ in a rural, low-income setting. Using random- and fixed-effects regressions, we studied how the proximity of key social contacts correlated with viral suppression dynamics among HIV-positive individuals. Respondents with social ties outside their immediate region had better-managed HIV viral suppression. Strong long ties, particularly those based on kinship and frequent communication, were most beneficial. These distant ties were most beneficial for individuals who lived alone, had less education, or were unemployed. The observed patterns highlight an important but less-discussed social network channel in older adults’ personal relationships. Findings emphasize that ties spanning greater geographic distances can be as important as close-proximity ties for healthy aging with HIV, particularly among those living alone and with fewer personal resources.

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