Patterns of Social Isolation and Engagement among Older Adults with HIV

Background: The HIV-positive population in the U.S. is graying; in 2007 35% of those living with HIV in New York City were over age 50, 73% were over age 40. A diagnosis of HIV often results in social isolation due to HIV stigma either when the person is rejected or as a form of self-protection (Emlet, 2006). Little is known about social isolation among older adults with HIV.

Methods: We examined social isolation using cluster analysis of social networks among 914 HIV-positive adults over age 50 (640 men, 264 women, & 10 transgender persons). The average age was 55.5 years, one-half were non-Hispanic Black and a third was Hispanic. The average time since HIV diagnosis was 12.6 years.

Results: Cluster analysis identified three groups. Isolates had only intermediate contact with children, little contact with other family, friends, or religious groups (32%). The Friend-Centered had contact with friends but not with children, family or religious groups (35%). The Integrated group had the broadest spectrum of relationships involving all types of kin and nonkin (33%). Women were least likely to be found in the Isolates group. Those in the Isolates group scored significantly lower on measures of psychosocial well-being compared to their peers (i.e., depression, loneliness, personal growth, and self-acceptance).

Conclusions: One-third of older adults with HIV find themselves in extreme social isolation. These findings underscore the need to reassess existing support services for adults aging with HIV in order to better serve the medical and psychosocial needs of this growing population.