HIV-Related Stigma in Midlife and Older Women

Abstract

HIV-related stigma has been identified as a barrier to HIV testing and prevention efforts internationally and nationally. Although the prevalence of HIV/AIDS is rapidly increasing in women aged 50 and older, little is known about the HIV-stigmatizing behaviors in this underserved population. In this exploratory analysis we investigated the influence of self esteem, sensation seeking, self silencing, and sexual assertiveness on the HIV-stigmatizing behaviors in 572 women aged 50 to 93. The variables considered in this analysis included subscales for the variables self silencing (Externalized Self Perception, Care as Self Sacrifice, Silencing the Self, Divided Self) and sexual assertiveness (Information Communication, Initiation, Refusal). Contributing predictive variables in the final model included: Self esteem (beta = -.190, t = -4.487, p = .000), Care as Self-Sacrifice (beta = .125, t = 2.714, p = .007), and Silencing the Self (beta = .164, t = 3.290, p = .001). Initiation (beta = .108, t = -2.619, p = .009) and Refusal (beta = -.091, t = -2.154, p = .032). Implications for social work and health perception regarding HIV prevention in midlife and older women are considered. Development of age- and gender-appropriate strategies assisting women in addressing HIV-stigma and related influences are addressed.

Psychosocial Predictors of Self-Esteem in a Multiethnic Sample of Women Over 50 at Risk for HIV

“…In spite of this, many women over 50 do not believe they are at risk for HIV infection (Jacobs & Kane, 2009, 2010Hillman, 2007) or may not know how to prevent HIV. Very few sexually active older women use condoms with regularity (Emlet & Farkas, 2001;Paranjape et al, 2006;Zablotsky & Kennedy, 2003).…”

“…The fear of being associated with an undesirable group may be exacerbated for an older woman whose self-esteem or feelings of self-worth (Crocker, 1999) may already be compromised by factors such as diminished economic resources and interpersonal dependency due to losing a spouse as well as the combined effects of sexism, racism, and ageism. Media campaigns targeted to women over 50 should be created to reduce the stigma surrounding HIV (Jacobs, 2008;Jacobs & Kane, 2010).…”

“…Although an increasing number of older American women are remaining sexually active because of healthier lifestyles and sexual-enhancement treatments, women over 50 are less likely than men to talk to their physician about HIV, believe that HIV has limited personal relevance (Jackson, Early, Myers-Schim, & Penprase, 2005;Jacobs, 2008;Jacobs & Kane, 2009, 2010Jacobs & Thomlison, 2009), possess very little knowledge of age-and gender-specific risk factors (Jacobs, 2008), and profess HIV-associated stigma (Hillman, 2007;Jacobs & Kane, 2010). HIV-related stigma can interfere with individual behavior change, and creates barriers to sexual communication, HIV testing, and condom use (Emlet, 2005;Herek et al, 1998).…”

HIV, Sexual Health, and Psychosocial Issues Among Older Adults Living with HIV in North America

“…Although sexuality is an important component of human nature, sexuality for older adults who are living with HIV is highly stigmatized. Older adults are often not recognized as sexual beings (Jacobs and Kane 2010) and therefore, resources that focus on sexuality are rarely targeted toward older adults (Orel et al 2004). This lack of focus on the needs of older adults is highly problematic.…”

“Trust Me, It’s Different”: Experiences of Peer Case Management of Women Living with HIV in Ontario, Canada

“…age, ethnicity, geographic region where they reside, or rural vs. urban community). This highlights the intersection of gender, HIV and stigma, which culminate to complicate the lives of WLWH across Ontario in accessing and receiving HIV and non-HIV support services (Jacobs & Kane, 2010). The intersectional model of HIV stigma, where HIV stigma is layered on a foundation of marginalized social identities and inequities related to sexism, racism and homo/transphobia, is well documented in the literature (Logie & al., 2011;Loutfy et al, 2012;Parker & Aggleton, 2003).…”