Intersectional stigma among midlife and older Black women living with HIV

Abstract

HIV-related stigma is a barrier to the prevention and treatment of HIV. For midlife and older Black women, the nature and intensity of HIV-related stigma may be compounded by their multiple marginalised social status based on gender, race, and age. We examined the perceptions and experiences of HIV-related stigma among midlife and older Black women living in Prince George’s County, Maryland, USA. Between 2014–2015, we conducted semi-structured interviews with a sample of 35 midlife and older Black women living with HIV. Using a modified grounded theory approach, we explored emergent themes related to the manifestation and experience of intersectional stigma and changes in stigma experience over time. Our findings suggest that intersectional stigma is a central feature in midlife and older Black women’s lives, with women reporting experiences of intersectional stigma at the interpersonal/familial, community, and institutional/structural levels. Although women acknowledged gradual acceptance of their HIV-positive status over time, they continued to experience negative responses related to gender, race, age, and disease. Our findings indicate that a more robust understanding of the impact of HIV-related stigma requires work to consider the complex manifestations of intersectional stigma among an increasingly aging population of Black women in the USA.

A longitudinal study of associations between HIV‐related stigma, recent violence and depression among women living with HIV in a Canadian cohort study

“…Intersectionality examines the interaction between multiple social identities that (re)produce privilege and marginalization . Intersectionality is a particularly salient framework for understanding the HIV epidemic, as race, class and gender disparities are structural drivers of HIV An emerging field of research on intersectional stigma assesses the effects of exposure to co‐occurring forms of stigma among WLHIV . Previous Canadian research with WLHIV highlights associations between racial discrimination , HIV‐related stigma , gender discrimination and depression .…”

Chronicity, crisis, and the ‘end of AIDS’

“…Although I use findings based on rapid ethnographic assessments from Louisiana and North Carolina (Sangaramoorthy & Kroeger 2013a; 2013b), in this paper, I focus primarily on previous work in Florida (Sangaramoorthy, 2012; 2014) and current work in Maryland (Sangaramoorthy, Jamison, & Dyer, 2017a; 2017b). The former, based on 15 months of ethnographic research in South Florida, documents an on-the-ground view of HIV/AIDS prevention programmes and their effect on the health and well-being of Haitians, a transnational immigrant community long plagued by the stigma of being AIDS carriers.…”

“…My most recent work in PGC is beginning to explore how scientific and research communities are unprepared for a largely ageing population living with HIV as well as the on-going issues related to HIV chronicity such as accelerated ageing, co-morbidity, and the uncertainties around long-term ART use (Sangaramoorthy, Jamison, & Dyer 2017a; 2017b). For midlife and older adults, living with HIV can be particularly challenging due to issues related to the loss of social support, management of comorbidities, and ageism (Sangaramoorthy, Jamison, & Dyer 2017b; Emlet, 2006a; Emlet 2006b).…”

“…For midlife and older adults, living with HIV can be particularly challenging due to issues related to the loss of social support, management of comorbidities, and ageism (Sangaramoorthy, Jamison, & Dyer 2017b; Emlet, 2006a; Emlet 2006b). The cumulative effect of years of ART on bodies and everyday lives is relatively unknown, and combined with the general physical and social effects of ageing itself, the context of ageing with HIV is complicated but understudied.…”

“…As I have written elsewhere, older Black women living with HIV reported multiple transformations in their experiences with HIV including HIV care and ART adherence as they aged with HIV (Sangaramoorthy, Jamison, & Dyer, 2017a; 2017b). Similar to research on chronic illness narratives (Garro 1992; Kralik, 2002), women described undergoing a period of disbelief, denial, uncertainty, fear, and ambivalence following a positive HIV diagnosis, ‘I didn’t want to believe it.…”