Stigma, isolation and depression among older adults living with HIV in rural areas

AbstractThere is a growing population of ageing individuals living with the human immunodeficiency virus (HIV). Older adults living with HIV often contend with intersecting stigmas including HIV stigma, ageism and, for some, homonegativity and/or racism. Although the HIV stigma literature is quite robust, research on the relationship between HIV stigma, social support and mental wellbeing among older adults living with HIV is limited. This study begins to address this gap by examining how intersectional stigma affects social support and mental wellbeing among rural-dwelling older adults living with HIV. Qualitative interviews were conducted by phone with 29 older adults living with HIV, over the age of 50, living in rural areas of the United States of America. Interviews were transcribed verbatim and analysed using thematic content analysis in MAXQDA qualitative analysis software. Analysis revealed three primary themes. The first had to do with gossip and non-disclosure of HIV status, which intersected with ageism and homonegativity to exacerbate experiences that fell within the remaining themes of experiences of physical and psychological isolation and loneliness, and shame and silence surrounding depression. The prevalence of social isolation and the effects of limited social support among older adults living with HIV are prominent and indicate a need for tailored interventions within the HIV care continuum for older adults living with HIV.

Download Full-text

3242 Stressful experiences and adherence to HIV care among Black Women Living with HIV: A qualitative analysis

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.174 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 74-74

Author(s):

Crystal Chapman Lambert ◽

Chastity McDavid ◽

Tammi F. Thomas ◽

Kiko King ◽

Andres Azuero ◽

...

Keyword(s):

Social Support ◽

Black Women ◽

Physical Abuse ◽

Traumatic Events ◽

The United States ◽

Stressful Events ◽

Hiv Care ◽

Care Clinic ◽

Women Living With Hiv ◽

Living With Hiv

OBJECTIVES/SPECIFIC AIMS: Our primary objective was to understand the relationship between incident or recent stressful events and adherence to HIV care in the context of other person, environment, and HIV-specific stressors in a sample of Black women living with HIV (WLWH). METHODS/STUDY POPULATION: Thirty in-depth interviews were conducted with Black women living with HIV who receive care at an academic HIV primary care clinic in the Southern region of the United States to elicit stressful events influencing adherence to HIV care. Semi-structured interview guides were used to facilitate discussion regarding stressful events and adherence to HIV care. Interviews were audiotaped and transcribed verbatim. Transcripts were independently coded using a theme-based approach by two experienced coders, findings were compared, and discrepancies were resolved by discussion. RESULTS/ANTICIPATED RESULTS: Participants described frequently experiencing incident stressful events including death or serious illness of a close friend or family member, and relationship, financial, and employment difficulties. Furthermore, participants reported experiencing traumatic events such as sexual and physical abuse during childhood and adolescents. While experiencing traumatic events such as sexual and physical abuse during childhood and adolescence may be distressing, these events did not influence adherence to HIV care. However, incident stressful events as defined above did influence adherence to HIV care for some participants, but not for others. For participants who reported that stressful events did not influence adherence to HIV care, factors such as personal motivation, access to social support, and adaptive coping strategies facilitated their engagement in care. DISCUSSION/SIGNIFICANCE OF IMPACT: Experiencing stressful events, incident or traumatic, is common among Black WLWH and have the potential to negatively influence adherence to HIV care. Thus, Interventions aimed at identifying and addressing stress, social support, and coping are essential to improve adherence to HIV care behaviors.

Download Full-text

The Influence of Social Networks and Supports on Depression Symptoms: Differential Pathways for Older Korean Immigrants and Non-Hispanic White Americans

Care Management Journals ◽

10.1891/1521-0987.17.1.13 ◽

2016 ◽

Vol 17 (1) ◽

pp. 13-23 ◽

Cited By ~ 2

Author(s):

Haesang Jeon ◽

James Lubben

Keyword(s):

Social Support ◽

Older Adults ◽

Social Networks ◽

Los Angeles ◽

The United States ◽

Korean Immigrants ◽

Equation Modeling ◽

Depression Symptoms ◽

Older Korean Immigrants ◽

Hispanic White

Objectives: The current cross-cultural study examines the pathways underlying different formations of social networks and social support systems, which affect depression symptoms among older Korean immigrants and non-Hispanic Whites in the United States.Method: Data for this study came from a panel survey of 223 older Korean American immigrants and 201 non-Hispanic White older adults 65 years of age and older living in Los Angeles. Structural equation modeling (SEM) is used to test the proposed conceptual model designed to explain the direct and indirect relationships between social networks and social support on depression symptoms.Results: Empirical evidence from this study indicated different effect of one’s social networks and social support on depression by race/ethnicity.Discussion: The work discussed in this article pointed to the need to recognize the role of culture in assessing the relationships between social networks, social support, and health among older adults.

Download Full-text

Psychosocial Determinants of HIV Stigma among Men Who Have Sex with Men in San Francisco, California

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158031 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8031

Author(s):

Dharma N. Bhatta ◽

Jennifer Hecht ◽

Shelley N. Facente

Keyword(s):

Mental Health ◽

San Francisco ◽

Age Groups ◽

Hiv Stigma ◽

Hiv Care ◽

People Living With Hiv ◽

Cross Sectional ◽

Adjusted Risk ◽

Sex With Men ◽

Living With Hiv

Background: Stigma and discrimination are major challenges faced by people living with HIV (PLWH), and stigma continues to be prevalent among PLWH. We conducted a cross-sectional study of 584 men who have sex with men (MSM) living with HIV between July 2018 and December 2020, designed to better understand which demographic and behavioral characteristics of MSM living with HIV in San Francisco, California are associated with experience of stigma, so that programs and initiatives can be tailored appropriately to minimize HIV stigma’s impacts. Methods: This analysis was conducted with data from San Francisco AIDS Foundation (SFAF) encompassing services from multiple different locations in San Francisco. Data about the level of HIV-related stigma experienced were collected through a single question incorporated into programmatic data collection forms at SFAF as part of the client record stored in SFAF’s electronic health record. We performed linear regression to determine the associations between self-reported experiences of HIV stigma and other characteristics among MSM living with HIV. Results: HIV stigma was low overall among MSM living with HIV who are actively engaged in HIV care in San Francisco; however, it was significantly higher for the age groups of 13–29 years (adjusted risk difference (ARD): 0.251, 95% CI: 0.012, 0.489) and 30–49 years (ARD: 0.205, 95% CI: 0.042, 0.367) when compared to the age group of 50 years and older, as well as people who were homeless (ARD: 0.844, 95% CI: 0.120, 1.568), unstably housed (ARD: 0.326, 95% CI: 0.109, 0.543) and/or having mental health concerns (ARD: 0.309, 95% CI: 0.075, 0.544), controlling for race, injection history, and viral load. Conclusions: These findings highlight an opportunity to develop culturally, socially, and racially appropriate interventions to reduce HIV stigma among MSM living with HIV, particularly for younger men and those struggling with housing stability and/or mental health.

Download Full-text

Reflections on Hip Fracture Recovery From Older Adults Enrolled in a Clinical Trial

Gerontology and Geriatric Medicine ◽

10.1177/2333721417697663 ◽

2017 ◽

Vol 3 ◽

pp. 233372141769766 ◽

Cited By ~ 4

Author(s):

Sarah Stott-Eveneshen ◽

Joanie Sims-Gould ◽

Megan M. McAllister ◽

Lena Fleig ◽

Heather M. Hanson ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Hip Fracture ◽

Controlled Trial ◽

Qualitative Interviews ◽

Management Program ◽

Knowledge Resources ◽

Study Staff ◽

Fracture Management ◽

Positive Perspective

This study describes patients’ perspectives on recovery during participation in a randomized controlled trial that tested a postoperative hip fracture management program (B4 Clinic), compared with usual care, on mobility. Semistructured qualitative interviews were conducted with 50 older adults with hip fracture (from both groups) twice over 12 months. A total of 32 women (64%) and 18 men (36%) participated in the study with a mean age at baseline of 82 (range = 65-98) years. A total of 40 participants reported recovery goals at some point during their recovery from hip fracture but only 18 participants realized their goals within 12 months. Recovering mobility, returning to prefracture activities, and obtaining stable health were the most commonly reported goals. Participants described good social support, access to physiotherapy, and positive perspective as most important to recovery. These factors were influenced by participants’ knowledge, resources, and monthly contact with study staff (perceived as a form of social support). The most frequently reported barriers to participants’ recovery were the onset of complications, pain, and limited access to physiotherapy. Potential implications of these findings include design and modification of new or preexisting fracture programs, prioritizing patient engagement and enhanced knowledge for future clinical research in hip fracture recovery.

Download Full-text

Urban-rural differences in the prevalence of muscle weakness and slow gait speed: A cross-sectional analysis from the NHANES (2001-2002 and 2011-2014)

Journal of Aging Research and Lifestyle ◽

10.14283/jarlife.2021.4 ◽

2021 ◽

pp. 1-7

Author(s):

J.J. Aziz ◽

K.F. Reid ◽

J.A. Batsis ◽

R.A. Fielding

Keyword(s):

United States ◽

Older Adults ◽

Grip Strength ◽

Muscle Weakness ◽

Rural Areas ◽

Gait Speed ◽

The United States ◽

Cross Sectional ◽

Comorbidity Burden ◽

Urban Rural

Background: Older adults living in rural areas suffer from health inequities compared to their urban counterparts. These include comorbidity burden, poor diet, and physical inactivity, which are also risk factors for sarcopenia, for which muscle weakness and slow gait speed are domains. To date, no study has examined urban-rural differences in the prevalence of muscle weakness and slow gait speed in older adults living in the United States. Objective: To compare the prevalence of grip strength weakness and slow gait speed between urban and rural older adults living in the United States. Design: A cross-sectional, secondary data analysis of two cohorts from the National Health and Nutrition Examination Survey (NHANES), using gait speed or grip strength data, and urban-rural residency, dietary, examination, questionnaire and demographic data. Participants: 2,923 adults (≥ 60 yrs.). Measures: Grip weakness was defined as either, an absolute grip strength of <35 kg. and <20 kg. or grip strength divided by body mass index (GripBMI) of <1.05 and <0.79 for men and women, respectively. Slow gait speed was defined as a usual gait speed of ≤0.8m/s. Results: The prevalence of GripBMI weakness was significantly higher in urban compared to rural participants (27.4% vs. 19.2%; p=0.001), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). No urban-rural differences in gait speed were observed. Conclusions: Older adults residing in urban regions of the United States were weaker compared to their rural counterparts. This report is the first to describe urban-rural differences in handgrip strength and slow gait speed in older adults living in the United States.

Download Full-text

Internalized HIV-Stigma, Mental Health, Coping and Perceived Social Support among People Living with HIV/AIDS in Aizawl District—A Pilot Study

Psychology ◽

10.4236/psych.2014.515186 ◽

2014 ◽

Vol 05 (15) ◽

pp. 1794-1812 ◽

Cited By ~ 6

Author(s):

Zoengpari Gohain ◽

Mary Ann L. Halliday

Keyword(s):

Mental Health ◽

Social Support ◽

Pilot Study ◽

Perceived Social Support ◽

Hiv Stigma ◽

People Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

Download Full-text

Social network members who engage in activities with older adults: do they bring more social benefits than other members?

Ageing and Society ◽

10.1017/s0144686x17001490 ◽

2018 ◽

Vol 39 (5) ◽

pp. 1050-1069 ◽

Cited By ~ 1

Author(s):

SATO ASHIDA ◽

DANIEL K. SEWELL ◽

ELLEN J. SCHAFER ◽

AUDREY SCHROER ◽

JULIA FRIBERG

Keyword(s):

Social Support ◽

Older Adults ◽

Social Network ◽

Social Influence ◽

Social Relationships ◽

Social Engagement ◽

The United States ◽

Social Benefits ◽

Social Activities ◽

Generalised Linear Mixed Model

ABSTRACTActive participation in social activities is important for the wellbeing of older adults. This study explored benefits of active social engagement by evaluating whether relationships that comprise active involvement (e.g. co-engagement in activities) bring more social benefits (i.e. social support, companionship, positive social influence) than other relationships that do not involve co-engagement. A total of 133 adults ages 60 years and older living in a rural Midwestern city in the United States of America were interviewed once and provided information on 1,740 social network members. Among 1,506 social relationships in which interactions occurred at least once a month, 52 per cent involved engagement in social activities together and 35 per cent involved eating together regularly. Results of the generalised linear mixed model showed that relationships involving co-engagement were significantly more likely to also convey social support (i.e. emotional, instrumental, informational), companionship and social influence (encouragement for healthy behaviours) than relationships that do not involve co-engagement. Having more network members who provide companionship was associated with higher sense of environmental mastery, positive relations with others and satisfaction with social network. Interventions may focus on maintaining and developing such social relationships and ensuring the presence of social settings in which co-engagement can occur. Future research may explore whether increasing co-engagement leads to an enhanced sense of companionship and psychological wellbeing.

Download Full-text