Stigma in an Aging Context

Both the Joint United Nations Program on HIV/AIDS and the US National HIV/AIDS Strategy identify HIV stigma as a barrier to care, a barrier to service access, and deleterious to personal and social well-being. This chapter discusses the topic of HIV stigma from a conceptual basis, including the mechanisms of prejudice and discrimination, and defining anticipated, enacted, and internalized stigma. Stigma is then placed in a historical context of HIV and AIDS, and events exacerbating HIV stigma are discussed. The components of HIV stigma are then applied to the population of older adults (age 50 years and older) who are at-risk of or living with HIV infection. The importance of intersectionality is discussed with regard to race, ethnicity, gender, sexual orientation, gender identity, and in particular, age. Drawing upon the HIV and gerontological literature, the chapter outlines characteristics found to be protective against stigma and placing older adults at greater risk for HIV stigma. Stigma management strategies are outlined and finally, implications of working with older adults related to HIV stigma are provided.