The Intersectionality of Stigmas among Key Populations of Older Adults Affected by HIV: a Thematic Analysis

ABSTRACT

Objectives: The present study examined the intersectionality of stigma across varying groups of older persons living with HIV (PWH).

Methods: Four focus groups of older PWH (gay/bisexual men, heterosexual men, heterosexual and bisexualwomen, and Spanish-speaking) were audio-recorded and transcribed. Inductive thematic text analysis was used to identify qualitative themes.

Results: Five major themes emerged from the data: 1) disclosure of HIV status; 2) types of stigma experienced; 3) discrimination experienced; 4) other outcomes associated with experiencing stigma; and 5) influence of aging on social isolation experienced due to stigma. Findings indicate women did not suffer from the intersection of stigmas. Other groups suffered from the intersection of stigma due to HIV status and age (gay/bisexual males); HIV status and perceived stigma of sexual orientation or drug use (heterosexual males); and HIV status and culture/ethnicity (Spanish-speaking).

Conclusions: Results indicate that many at-risk groups, including heterosexual men, homosexual men, and Spanish-speaking individuals, experience an intersection of stigma between aging and their sexuality, HIV status, or real or perceived drug use.

Clinical Implications: Results highlight the need for HIV support, especially social support, to address intersection of stigmas for unique groups of individuals disproportionately affected by HIV.

KEYWORDS:

• Ageism
• discrimination
• gay/bisexual
• heterosexual male
• HIV stigma
• loneliness
• social isolation

Acknowledgments

Eugenia Siegler received support from the Fan Fox and Leslie R. Samuels Foundation. She is also is an investigator on an approved investigator-initiated research grant from Gilead Sciences. Ryann Freeman also received Samuels Foundation support. Stephen Karpiak, Mark Brennan-Ing, and Liz Seidel receive support from the M·A·C AIDS Fund and the New York Community Trust. Dr. Shen received funding from an NCI K07 Award (K07-CA207580).

Compliance with Ethical Standards

The authors have no financial other interests or conflicts to report. All research was collected with IRB approval from participating institutions and the accepted principles of ethical and professional conduct has been followed. All research participants provided informed consent prior to engaging in study procedures.

Research Involving Human Participants

All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and/or national research committee and with the 1965 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

Funding

This work was supported by the National Cancer Institute [K07-CA207580]; New York Community Trust; M-A-C Funding (Seidel, Freeman, and Brennan-ing); Fan Fox and Leslie R. Samuels Foundation (Eugenia Siegler & Ryann Freeman); Gilead Sciences (Eugenia Seigler).