Stigma and survival in older adult sexual minority men living with HIV/AIDS in New York City

Background: The proportion of HIV/AIDS cases in older adults has nearly doubled in recent years. Recent projections estimate that in the next decade the greatest proportion of PLWHA (people living with HIV/AIDS) living in the United States will be older than fifty. However, few studies have examined the experiences of older sexual minority men living with HIV/AIDS. Attending to this gap, this study examines the ways in which older adult sexual minority men narrate the role of stigma in their ability to survive with HIV/AIDS. Method: In depth interviews were conducted with thirty New York City sexual minority men fifty and older who have been living with HIV for thirteen or more years. Systematic sampling was used to achieve equal distribution across ethnic/racial groups, such that the sample includes ten blacks, ten Latinos, and ten whites. Grounded theory guided the development of a codebook, which investigators used to code interviews, focusing on the theme of stigma. Results: Respondents articulate that stigma related to HIV status, sexual orientation, ethnicity and age has deeply impeded their ability to cope with HIV/AIDS over time. However, respondents employ multiple stigma management techniques in order to manage and resist the health-demoting influence of stigma. Conclusion: Stigma remains a major barrier in the ability of older PLWHA survive with HIV/AIDS. Future research is needed in order to develop empowering ways in which older PLWHA can mitigate the influence of stigma, as well as to develop ways to eradicate the structural sources of stigma in their lives.