scholarly journals Barriers to Successful Aging Among Older Women Living With HIV: A Qualitative Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 498-499
Author(s):  
Anna Rubtsova ◽  
Tonya Taylor ◽  
Gina Wingood ◽  
Igho Ofotokun ◽  
Deborah Gustafson ◽  
...  

Abstract Successful aging (SA) is the capacity of older people to thrive despite age-related changes and/or declines. Although our previous research found that older (age ≥50) women living with HIV (OWLH) can achieve SA, considerable barriers remain. The purpose of this qualitative study was to identify specific barriers to SA among OWLH. Our sample consisted of 29 OWLH recruited between October 2018 and March 2019 at two sites of Women’s Interagency HIV Study (WIHS): Atlanta, GA and Brooklyn, NY. These participants were assigned to either semi-structured interviews (N=17: 8 interviews in Brooklyn and 9 in Atlanta) or focus group discussions (FGD: 1 FGD in Atlanta with 5 participants, and 1 FGD in Brooklyn with 7 participants). Our FGD and Interview Guides included questions focused on barriers to SA. Participants were, on average, 58 years old (range 50-73), 86% Black, 83% single, and 62% with annual income ≤ $12,000. All interviews and FGD were transcribed and coded using MAXQDA software. We used thematic coding within constructivist approach. Several themes emerged identifying the following SA barriers: multiple chronic conditions and pain (e.g., arthritis, neuropathy); polypharmacy and side effects of HIV medications (“it’s wearing on me”); HIV-related stigma and loneliness (“I think my children would judge me if I would tell them I have it HIV”); substance use, giving up on yourself (“just sitting around, not doing anything”); and lack of access to resources and services (e.g., mental health providers, support groups). Our findings will help designing public health interventions promoting SA among OWLH.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S765-S765
Author(s):  
Anna A Rubtsova ◽  
Tonya Taylor ◽  
Gina Wingood ◽  
Igho Ofotokun ◽  
Deborah Gustafson ◽  
...  

Abstract Little is known about successful aging (SA) among older (50+) women living with HIV (OWLH). Therefore, the purpose of this qualitative study was to examine subjective understandings of SA among OWLH. Participants were OWLH enrolled in the Women’s Interagency HIV Study (WIHS) and those not enrolled in WIHS: 8 in Atlanta, GA (3 WIHS and 5 non-WIHS) and 9 in Brooklyn, NY (6 WIHS and 3 non-WIHS). Semi-structured interviews ranged from 30 to 120 minutes. Several themes emerged in participants’ definitions of SA, e.g. self-care, taking HIV medications, and being resilient (“HIV made me stronger”). Both WIHS and non-WIHS participants emphasized life course perspective in their definitions of SA -- women viewed their aging successful as a more stable phase of life in contrast to hardships they experienced while being younger (e.g., drug use, incarceration). Data collection efforts are ongoing and will allow further characterization of SA among this population.


2016 ◽  
Vol 21 (9) ◽  
pp. 2589-2599 ◽  
Author(s):  
Christine Tagliaferri Rael ◽  
Alex Carballo-Diéguez ◽  
Rachel Norton ◽  
Eryka Thorley ◽  
Rebecca Giguere ◽  
...  

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 424-424
Author(s):  
David Moore ◽  
Dilip Jeste ◽  
Marcia Holstad ◽  
Anna Rubtsova

Abstract The overall purpose of this qualitative study was to examine barriers and facilitators of successful aging among older men living with HIV (OMLH). Participants were recruited through HIV Neurobehavioral Research Program at the University of California, San Diego. Our sample included 14 OMLH: average age - 62 years old (range: 53 to 72), 79% white, 43% living alone, 79% men who have sex with men, 57% having college education or higher. Semi-structured interviews lasted from 43 to 114 minutes and were fully transcribed. Several themes emerged related to perceived barriers to successful aging stemming from social institutions: i.e., age discrimination and ageism, sexual and HIV-related stigma, social isolation, lack of resources, and food insecurity. Perceived institutional solutions promoting successful aging included mixed-age/inter-generational support groups, computer literacy training, health education, information and resources related to healthy lifestyle on a limited budget, and increased transparency of resources available to older adults.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara Chace Dwyer ◽  
Aparna Jain ◽  
Wilson Liambila ◽  
Charlotte E. Warren

Abstract Background Kenya has successfully expanded HIV treatment, but HIV-related stigma and discrimination, and unintended pregnancy remain issues for many Kenyan women living with HIV. While HIV-related stigma can influence the health seeking behaviors of those living with HIV, less is known about how reproductive health outcomes influence internalized stigma among women living with HIV. Methods Baseline data only were used in this analysis and came from an implementation science study conducted in Kenya from 2015 to 2017. The analytic sample was limited to 1116 women who are living with HIV, between 18 to 44 years old, and have ever experienced a pregnancy. The outcome variable was constructed from 7 internalized stigma statements and agreement with at least 3 statements was categorized as medium/high levels of internalized stigma. Unintended pregnancy, categorized as unintended if the last pregnancy was mistimed or unwanted, was the key independent variable. Univariate and multivariate logistic regression models were used to assess the association between unintended pregnancy and internalized stigma. Associations between internalized stigma and HIV-related discrimination and violence/abuse were also explored. Results About 48% agreed with at least one internalized stigma statement and 19% agreed with at least three. Over half of women reported that their last pregnancy was unintended (59%). Within the year preceding the survey, 52% reported experiencing discrimination and 41% reported experiencing violence or abuse due to their HIV status. Women whose last pregnancy was unintended were 1.6 times (95% CI 1.2–2.3) more likely to have medium/high levels of internalized stigma compared to those whose pregnancy was wanted at the time, adjusting for respondents’ characteristics, experiences of discrimination, and experiences of violence and abuse. Women who experienced HIV-related discrimination in the past 12 months were 1.8 times (95% CI 1.3–2.6) more likely to have medium/high levels of internalized stigma compared to those who experienced no discrimination. Conclusions Results suggest that unintended pregnancy is associated with internalized stigma. Integrated HIV and FP programs in Kenya should continue to address stigma and discrimination while increasing access to comprehensive voluntary family planning services for women living with HIV.


Author(s):  
Charles Patrick Namisi ◽  
John C. Munene ◽  
Rhoda K. Wanyenze ◽  
Anne R. Katahoire ◽  
Rosalinda M. Parkes-Ratanshi ◽  
...  

Abstract Aims This study aimed to determine the prevalence of, factors associated with, and to build a theoretical framework for understanding Internalsed HIV-related Stigma Mastery (IHSM). Methods A cross-sectional study nested within a 2014 Stigma Reduction Cohort in Uganda was used. The PLHIV Stigma Index version 2008, was used to collect data from a random sample of 666 people living with HIV (PLHIV) stratified by gender and age. SPSS24 with Amos27 softwares were used to build a sequential-mediation model. Results The majority of participants were women (65%), aged ≥ 40 years (57%). Overall, IHSM was 45.5% among PLHIV, that increased with age. Specifically, higher IHSM correlated with men and older women “masculine identities” self-disclosure of HIV-diagnosis to family, sharing experiences with peers. However, lower IHSM correlated with feminine gender, the experience of social exclusion stress, fear of future rejection, and fear of social intimacy. Thus, IHSM social exclusion with its negative effects and age-related cognition are integrated into a multidimensional IHSM theoretical framework with a good model-to-data fit. Conclusion Internalised HIV-related Stigma Mastery is common among men and older women. Specificially, “masculine identities” self-disclose their own HIV-positive diagnosis to their family, share experiences with peers to create good relationships for actualising or empowerment in stigma mastery. However, social exclusion exacerbates series of negative effects that finally undermine stigma mastery by young feminine identities. Thus, stigma mastery is best explained by an integrated empowerment framework, that has implications for future practice, policy, and stigma-related research that we discuss.


2020 ◽  
Vol 10 ◽  
pp. 2235042X2098119
Author(s):  
Jenny Ploeg ◽  
Anna Garnett ◽  
Kimberly D Fraser ◽  
Lisa Garland Baird ◽  
Sharon Kaasalainen ◽  
...  

Background: Older adults with multiple chronic conditions (MCC) rely heavily on caregivers for assistance with care. However, we know little about their psychosocial experiences and their needs for support in managing MCC. The purpose of this study was to explore the experiences of caregivers of older adults living in the community with MCC. Methods: This qualitative study was a secondary analysis of previously collected data from caregivers in Ontario and Alberta, Canada. Participants included caregivers of older adults (65 years and older) with three or more chronic conditions. Data were collected through in-depth, semi-structured interviews. Interview transcripts were coded and analyzed using Thorne’s interpretive description approach. Results: Most of the 47 caregiver participants were female (76.6%), aged 65 years of age or older (61.7%), married (87.2%) and were spouses to the care recipient (68.1%). Caregivers’ experiences of caring for community-living older adults with MCC were complex and included: (a) dealing with the demands of caregiving; (b) prioritizing chronic conditions; (c) living with my own health limitations; (d) feeling socially isolated and constrained; (e) remaining committed to caring; and (f) reaping the rewards of caregiving. Conclusions: Healthcare providers can play key roles in supporting caregivers of older adults with MCC by providing education and support on managing MCC, actively engaging them in goal setting and care planning, and linking them to appropriate community health and social support services. Communities can create environments that support caregivers in areas such as social participation, social inclusion, and community support and health services.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Renessa S. Williams ◽  
Nichole E. Stetten ◽  
Christa Cook ◽  
Robert Cook ◽  
Miriam O. Ezenwa ◽  
...  

2021 ◽  
Vol 11 ◽  
Author(s):  
Obadia Yator ◽  
Muthoni Mathai ◽  
Tele Albert ◽  
Manasi Kumar

Background: We look at how various HIV-related stigma subtypes, especially internalizing types, interact with postpartum depression (PPD) among women living with HIV. Additionally, we identify key psychosocial risk factors that influence stigma and PPD among women attending Prevention of Mother-to-Child Transmission (PMTCT) clinics.Methods: In this cross-sectional design, 123 women living with HIV were recruited. Participants ages between 18 and 50, who were at least 8 weeks postpartum seeking PMTCT services at Kenyatta National Hospital (KNH), between June and September 2014 participated in the study. HIV/AIDS Stigma Instrument—PLWHA (HASI–P) was used to assesses stigma and Postpartum depression was assessed by Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariate regression models were used to determine the individual characteristics associated with the HIV-related stigma Scale. Post survey a few in-depth-interviews were conducted to explore individuals' stigma and depression experiences.Results: The mean age was 31.2 years (SD = 5.2). Fifty-nine (48%) women screened positive for significant depressive symptoms. Post-partum depression was a significant predictor of internalized stigma, enacted, and total stigma (P < 0.05). Older age was associated with less internalized stigma. Living with a partner was associated with more internalized stigma. Having an income above 100 USD per month was protective against stigma. Having good family social support was protective against internalized stigma. A higher educational level was protective against enacted stigma. Being treated for STIs was a risk factor for both enacted and overall stigma.Conclusions: HIV-related stigma needs to be addressed through integrated mental health care programs in PMTCT. Postpartum depression requires comprehensive management to improve short- and long-term outcomes of women living with HIV.


2021 ◽  
Author(s):  
Anne C. Wagner

The current investigation seeks to examine the attitudes and beliefs of health care providers in Canada about people living with HIV. The line of research consists of three studies. Study 1 was a qualitative study conducted with a critical lens. The critical lens was used in a series of four focus groups when qualitatively soliciting opinions about the range of attitudes, behaviours and cognitions health care providers may have towards people living with HIV. Study 2 used the information gathered from Study 1 to develop a scale to assess HIV stigma in health care providers. Items were created from examples and themes found in the qualitative study, and were tested via exploratory factor analysis, confirmatory factor analysis, test-retest reliability analysis, and assessed for convergent and divergent validity. Study 3 examined the newly developed scale’s relationship to proposed overlapping stigmas and attitudes, and tested the adapted intersectional model of HIV-related stigma with health care trainees using the newly developed HIV stigma scale as an outcome measure. The line of research found that HIV stigma continues to be a significant problem in the health care system. The scale developed in Study 2 demonstrates that HIV stigma can be conceptualized and assessed as a tripartite model of discrimination, stereotyping and prejudice, and that this conceptualization of HIV stigma supports an intersectional model of overlapping stigmas with homophobia, racism, stigma against injection drug use and stigma against sex work.


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