Online Program

HIV-related shame and quality of life in a sample of persons living with HIV/AIDS over 50 years of age

Tuesday, November 5, 2013 : 5:15 p.m. - 5:30 p.m.

Wilson Vincent, Ph.D., Division of Prevention and Community Research, Yale University School of Medicine, New Haven, CT
Sarah K. Calabrese, Ph.D., Yale School of Public Health/ Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT
Xindi Fang, B.S., Yale School of Public Health, Yale University, New Haven, CT
Timothy G. Heckman, Ph.D., College of Public Health, University of Georgia, Athens, GA
Kathleen J. Sikkema, Ph.D., Department of Psychology and Neuroscience, Duke University, Durham, NC
Nathan B. Hansen, Ph.D., Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT
Background. As the proportion of persons living with HIV/AIDS (PLWHA) aged 50 years and older increases, health professionals must understand how HIV-related shame may affect aging populations. This study aimed to determine how HIV-related shame is associated with health-related quality of life (HRQoL) among diverse PLWHA aged 50 and older.

Method. A multisite sample of 299, predominantly male, racially and ethnically diverse PLWHA over 50 involved in a randomized clinical trial completed study measures. Structural equation modeling determined whether HIV-related shame was (1) directly associated with five dimensions of HRQoL (physical, emotional, functional and global, and social, and cognitive well-being); and (2) indirectly associated with HRQoL via loneliness and depression. Direct and indirect associations were tested for moderation across levels of race, ethnicity, gender, age at diagnosis, and HIV-related discrimination.

Results. The final model of direct and indirect associations via loneliness and depression of HIV-related shame with five dimensions of HRQoL adequately fit the data based on fit indices that were relatively robust to sample size, χ2 (499, N=299)=1046.684, p<.000, SRMR=.06, TLI=.93, RMSEA=.06 (95% CI: .055-.066). Few moderation effects were detected.

Conclusions. Across diverse, HIV-positive older adults, HIV-related shame may be directly associated with adverse HRQoL and may play a role in the links between depression, loneliness, and poor HRQoL. Given the modifiability of affective states such as shame, psychosocial interventions for older PLWHA should target HIV-related shame in addition to depression and loneliness.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe how HIV-related shame may be linked to health-related quality of life among older, HIV-positive adults. Compare groups among older adults to identify potential disparities in how HIV-related shame is associated with health-related quality of life.

Keyword(s): HIV/AIDS, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a predoctoral fellow at Yale University School of Medicine with interests in HIV/AIDS and stigma as they affect marginalized populations. These interests are reflected in my past and current work, which includes applied community work with persons living with HIV/AIDS and helping to develop, conduct, and publish on federally and intramurally funded research projects.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.