Stigma-Related Disclosure Concerns and Negative Self-Image Have Not Improved Over a Decade in Older People With HIV

Area of Science:

• Gerontology
• Infectious Diseases
• Psychiatry

Background:

• Stigma significantly impacts the HIV care continuum, mental health, adherence, and quality of life for people with HIV (PWH).
• Longitudinal data on HIV stigma among aging PWH is limited, hindering targeted interventions.

Purpose of the Study:

• To prospectively analyze changes in HIV stigma measures over a 10-year period in older PWH.
• To identify sociodemographic and clinical factors associated with changes in HIV stigma over time.

Main Methods:

• The AGEhIV Cohort Study prospectively followed PWH, assessing the full Berger HIV Stigma Scale (HSS) at baseline (T0) and two subscales (disclosure concerns, negative self-image) at 10-year follow-up (T1).
• Paired samples t-tests analyzed score changes over time.
• Linear regression and linear mixed models identified associated factors.

Main Results:

• Disclosure concerns scores decreased minimally, while negative self-image scores remained stable over 10 years.
• No factors were associated with changes in disclosure concerns.
• Women showed significantly higher increases in negative self-image scores.
• Higher negative self-image was linked to attraction to both men and women and moderate to severe depressive symptoms.
• Both stigma domains were negatively associated with years since HIV diagnosis.

Conclusions:

• HIV stigma, specifically disclosure concerns and negative self-image, did not improve in a cohort of older PWH over a decade.
• HIV stigma worsened among women and was associated with living in larger households and experiencing moderate to severe depression.