Barriers and Facilitators to Promoting Resilience to HIV/AIDS: A Qualitative Study on the Lived Experiences of HIV-Positive, Racial and Ethnic Minority, Middle-Aged and Older Men Who Have Sex with Men from Ontario, Canada

Abstract

Evidence-based research has highlighted the need for exploring factors that support the mental health of men who have sex with men living with HIV/AIDS (MSMLWH), and environmental influences that promote their resilience to HIV/AIDS. This exploratory study utilized a community-based participatory research approach to investigate barriers and facilitators to promoting resilience to HIV/AIDS, specifically among racial and ethnic minority, middle-aged and older MSMLWH, a population that continues to be significantly impacted by HIV/AIDS today. This collaborative, qualitative study recruited participants who identified as racial or ethnic minority MSMLWH, were aged 40 or older, and resided in Ontario, Canada. Participants (n = 24) discussed in their interviews barriers and facilitators to promoting resilience to HIV/AIDS, which they recognized from their lived experiences. Utilizing thematic analysis, themes related to barriers and facilitators to promoting resilience to HIV/AIDS were identified. Themes related to identified barriers included: (1) language proficiency, (2) racism, (3) pernicious norms in North American gay culture, and (4) HIV stigma. Themes related to identified facilitators included: (1) compartmentalization, (2) perseverance, and (3) community-based health and social services. This article discusses the implications of the study’s findings, particularly on how they may influence the development of future services for racial and ethnic minority, middle-aged and older MSMLWH.

Kinky Sex and Deliberate Partner Negotiations: Case Studies of Canadian Transgender Men Who Have Sex with Men, Their HIV Risks, Safer Sex Practices, and Prevention Needs

“…In the case of TMSM, this reliance on and great appreciation of social engagement, social support, and accessible community resources were distinctly exemplified by the experiences and sentiments described in all three case studies. Several research studies have emphasized the benefits gained by MSM and trans individuals from having perceived social support from LGBTQIA+ friends [ 65 , 66 , 67 , 68 , 69 ], and strong connections with gender-affirming communities and sexual health care [ 46 , 47 , 51 , 52 , 53 , 65 ], especially those that prioritize the elimination of cisgenderism and transphobia [ 70 ]. They have also emphasized the need for such HIV services and programs to create sustainable opportunities to increase the financial security of TMSM, as well as develop more opportunities for TMSM to receive gender affirmation and social support from accessible community resources.…”

Promoting Resilience among Middle-Aged and Older Men Who Have Sex with Men Living with HIV/AIDS in Southern Nevada: An Examination of Facilitators and Challenges from a Social Determinants of Health Perspective

“…Recent studies have explored and discussed a variety of factors that have either prospectively served as facilitators to the promotion of resilience to HIV/AIDS among MSM living with HIV/AIDS, or as barriers and challenges to such resilience-building [20,[28][29][30][31]. Examples of facilitators that have been explored include individual characteristics such as perseverance [30,31]; external protective factors such as social support from family and friends, religion and spirituality, and education [16,20,26]; and community-level resources such as lesbian, gay, bisexual, trans, queer, and intersex (LGBTQI+) not-for-profit agencies and AIDS services organizations [17,[32][33][34].…”

“…Recent studies have explored and discussed a variety of factors that have either prospectively served as facilitators to the promotion of resilience to HIV/AIDS among MSM living with HIV/AIDS, or as barriers and challenges to such resilience-building [20,[28][29][30][31]. Examples of facilitators that have been explored include individual characteristics such as perseverance [30,31]; external protective factors such as social support from family and friends, religion and spirituality, and education [16,20,26]; and community-level resources such as lesbian, gay, bisexual, trans, queer, and intersex (LGBTQI+) not-for-profit agencies and AIDS services organizations [17,[32][33][34]. Examples of challenges that have been examined in the research include HIV stigma and discrimination (i.e., negative attitudes toward HIV/AIDS and the negative treatment of PLWH that have been found to exacerbate social isolation and other co-occurring psychosocial health problems) [17,20,24,30,31,35], cultural and language barriers, and racism [30].…”

“…Examples of facilitators that have been explored include individual characteristics such as perseverance [30,31]; external protective factors such as social support from family and friends, religion and spirituality, and education [16,20,26]; and community-level resources such as lesbian, gay, bisexual, trans, queer, and intersex (LGBTQI+) not-for-profit agencies and AIDS services organizations [17,[32][33][34]. Examples of challenges that have been examined in the research include HIV stigma and discrimination (i.e., negative attitudes toward HIV/AIDS and the negative treatment of PLWH that have been found to exacerbate social isolation and other co-occurring psychosocial health problems) [17,20,24,30,31,35], cultural and language barriers, and racism [30]. Other studies have discussed factors that may have served as facilitators or challenges to promoting resilience to HIV/AIDS among middle-aged and older MSM living with HIV/AIDS and other PLWH, and described how these factors may have exerted their influence through their impacts on various social determinants of health [36,37].…”

Sexual Practices and Predisposition to PrEP Use Among Men Ages 50 Years and Older Who Have Sex With Men: A Cross-Sectional Study

“…Furthermore, it should be considered that studies indicate that MSM who are older often fail to recognize their susceptibility to HIV and other STIs, leading to inadequate uptake of prevention methods (Hawkinson et al, 2023;Liboro et al, 2021;Queiroz et al, 2023;Roberson, 2018). Research conducted in Brazil has shown high rates of inconsistent condom use in this population, highlighting an urgent need to provide additional prevention measures (Queiroz, Sousa, et al, 2019;Queiroz et al, 2023;Serra et al, 2013;Sousa et al, 2019).…”