Diversity, stigma, and social integration among older adults with HIV
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The population of people with HIV is aging globally as access to anti-retroviral therapy becomes more widely available. The diversity of older population with HIV has an impact on their experiences of stigma. HIV stigma may be enacted or felt. Enacted stigma is the prejudice, discrimination, and mistreatment that individuals and societies use to sanction people with HIV. Felt stigma refers to the internalized feelings of shame, guilt, and fear that arise from enacted stigma. Nondisclosure is rooted in the fear of negative consequences of revealing one’s HIV status, such as losing a job, or being rejected by one’s social network. Stigma may also affect social integration through self-protective withdrawal to avoid anticipated stigma. In addition to facing HIV stigma, people with HIV may possess multiple discredited identities due to their race, ethnicity, gender identity, etc., which is described as intersectionality. Older age represents an additional intersectional identity that affects people with HIV through the experience of ageism. Stigma and discrimination from HIV or any discredited identity are linked to poorer physical and mental health outcomes. Given the pervasiveness of stigma, it is not surprising that many older adults with HIV are socially isolated and report greater self-perceived stigma compared to those who are more socially integrated. While there is evidence that HIV stigma has declined compared to previous eras, more research is needed on HIV stigma among older adults in low- and middle-income countries to design policies and programs to combat HIV stigma globally.
KeywordsIntersectionality Ageism Social isolation Physical health Mental health
Thanks to Austin Gerhard Oswald, MA, and Erica Thomas, RN for their assistance with the literature review for this article. Thanks also to Jamie Frankenberg, LMSW for reviewing an earlier version of this article.
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Conflict of interest
The author has no conflict of interest to report regarding this article.
This article does not contain any studies with human participants or animals performed by any of the authors.
For this type of study formal consent is not required.
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