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"There's no retirement plans for us": Re-analysis
from a qualitative study of HIV-positive MSM who use substances
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"ageism is an additional intersecting stigma affecting MSM living with HIV and problematic substance use that is associated with loneness, isolation, and depressed mood.....need for social and emotional support for aging HIV-positive MSM, to improve peer connectedness, and reduce social isolation and depressive symptoms. More research is needed to identify effective strategies for reducing loneliness among aging MSM living with HIV and problematic substance us"
FROM JULES: AS MANY OF YOU KNOW I HAVE DEDICATED MY SELF & RESOURCES OF NATAP TO POLICY, ADVOCACY AND changing the HIV Care Infrastructure (RWCA) to meet the clinical & community & daily unmet needs of aging older HIV+ suffering the consequences of accelerated or premature aging in HI, where we have 2-5 times vs HIV-neg. the rates of comorbidities, frailty, kidney disease, heart disease, diabetes, cancers, and there are BIG gaps in support services in the clinic & community AND better care is needed: more time at visits with clinicians & more attention from clinicians, and better & more effective interactions between specialists & doctor & patient; as well many clinicians & doctors need education about each comorbidity care & prevention, treatment.
A. Thiim1, J. Kim2, E. Lam1, C. O'Cleirigh1,3,4, K. Mayer1,4, A. Batchelder1,3,4
1Fenway Institute, Behavioral Sciences Research Program, Boston, United States, 2Massachusetts General Hospital and Harvard Medical School, Department of Psychiatry, Boston, United States, 3Massachusetts General Hospital, Department of Psychiatry, Boston, United States, 4Harvard Medical School, Boston, United States
Background: Following the advent of ART, we have seen drastic decreases in morbidity and mortality rates among people living with HIV in the U.S., including men who have sex with men (MSM), who remain disproportionately affected by HIV. While people living with HIV are living longer healthier lives there is a growing body of evidence indicating severe degrees of loneliness and isolation among those in their senior-years.
Methods: We conducted a secondary data analysis from a larger study, which aimed to assess perceptions of relationships between intersecting internalized stigmas related to sexual orientation, HIV-stigma, and substance use stigma and HIV self-care. Using 16 of the original 33 interviews, we used thematic analyses informed by grounded theory to investigate the relationships between aging, loneliness and social connections among participants who described aging related stress.
Results: This sample of 16 people had a mean age of 54.4 years (SD 8.57) and a range of 30-68 years, with 88% being ≥50 years old. Additionally, 62.5% identified as African American, 25% White, and 13% as bi- or multi-racial. Over half identified as gay and 44% as bisexual. Nearly 95% reported annual incomes of ≤$20,000 and 31% had ≤ high school education.
Themes related to loneliness and isolation emerged involving coping with fear of rejection via avoidance and substance use.
Participants described ageism, in the context of social connections, like dating and meeting sexual partners, worsening feelings of loneliness.
Many people described depressive feelings related to feeling old and surprised to have reached their age.
Conclusions: Together, our results convey that ageism is an additional intersecting stigma affecting MSM living with HIV and problematic substance use that is associated with loneness, isolation, and depressed mood.
These results indicate the need for social and emotional support for aging HIV-positive MSM, to improve peer connectedness, and reduce social isolation and depressive symptoms. More research is needed to identify effective strategies for reducing loneliness among aging MSM living with HIV and problematic substance use.
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