141st APHA Annual Meeting

In This section

286950
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 PM - 5:30 PM

Wilson Vincent, M.A. , Division of Prevention and Community Research, Yale University School of Medicine, New Haven, CT
Sarah K. Calabrese, Ph.D. , 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.

Keywords: 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.