|My age:||I am 50|
Try out PMC Labs and tell us what you think. Learn More. Little is known about specific challenges older HIV-infected women face in coping with the disease and its attendant stressors. To understand these issues for older women, we conducted semi-structured in-depth interviews with 15 women 13 African American, 2 Caucasian 50 years of age and older range 50—79 in HIV care in the Southeastern United States, and coded transcripts for salient themes. Many women felt isolated and inhibited from seeking social connection due to reluctance to disclose their HIV status, which they viewed as more shameful at their older ages.
Those receiving social support did so mainly through relationships with family and friends, rather than romantic relationships. Spirituality provided great support for all participants, although fear of disclosure led several to restrict connections with a church community. Community-level stigma-reduction programs may help older HIV-infected women receive support. Approximately one quarter of the estimated 1.
“i should know better”: the roles of relationships, spirituality, disclosure, stigma, and shame for older women living with hiv seeking support in the south
Research has suggested that older people may Mature women who want sex Faith North Carolina living with HIV differently than those who are younger. Generally, older patients have been found to be more adherent to their ARV medications than younger patients, but their adherence is more sensitive to weakened cognitive function and substance abuse problems Barclay et al.
Similarly, the experience of aging may differ between those who are living with HIV and those who are not. Research has suggested that social support may be particularly important for older HIV-infected people. The particular challenges of older women living with HIV have not been separated from those of men. More specifically, the psychosocial experiences of older women living with HIV have not been fully described. These trends indicate the increasing need to understand the experiences of older women living with HIV.
In-depth, semi-structured, qualitative interviews were conducted with 15 women, with each interview lasting about 1 hour. Examples of the general questions used to invite exploration of these issues included, What are some challenging aspects of your day-today life? Women were also asked more specific probes to provide opportunities to elaborate on specific psychosocial factors such as social stressors and support, emotional reactions to aspects of living with HIV, perceptions of faith, and personal and social responsibilities.
These probes were refined continuously during data collection to ensure exploration of relevant themes emerging in the interviews.
Examples of such probes included, Tell me about your home and the people who live there. Are you responsible for the well-being of any of these individuals? This study took place at a public-hospital-based infectious diseases clinic. All women who were HIV-infected, English-speaking, ages 50 years or older, receiving care at the clinic between May and Novemberand ly consented to be approached for research studies, were invited.
Two women declined due to time constraints dictated by transportation departure times.
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Written informed consent was obtained before each interview. Interviews were held in a private location in the clinic. The institutional review board of the University of North Carolina at Chapel Hill approved the study protocol. During the data collection period, each interview was transcribed verbatim and reviewed by the interviewer MA shortly after completion. The interviewer conducted continuous comparative analysis between transcribed interviews in groups of five, through which commonalities in the interviews were identified, categorized, and compared.
Then they grouped the list of codes into conceptual or themes, which were refined into a codebook.
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The same three researchers each Mature women who want sex Faith North Carolina the codebook to code two randomly selected transcripts using NVivo 9 software, compared the codes they applied, resolved any discrepancies through discussion, and revised the codebook as needed based on that process. Final refinements to the codebook were made after applying a similar approach to five more transcripts. The remaining eight interviews were independently ased codes. The demographic features of the 15 study participants are shown in Table 1. Of the four sexually active women, one was married to an HIV-uninfected man, two had HIV-infected intimate partners one was married to her partner and one referred to him as her boyfriendand one reported occasional sexual activity with a male friend but did not specify his HIV status.
Three of the four sexually active women reported consistent condom use; one woman reported inconsistent condom use with her HIV-infected partner. The women discussed three types of relationships that were sources of potential or actual support in their lives: a family and platonic relationships, b romantic partnerships, and c relationships with a church community and with God. Within each type of relationship, salient themes emerged that reflected two general issues: a the types of support received, and b factors that helped or hindered accessing that potential source of support.
The main sources of social support women listed were close family members. The women specifically mentioned their grown daughters as sources of social support, and described their daughters as helping with transportation to appointments, taking medications, meal preparation, and housing, as well as being someone with whom they could talk and have fun. Two of the older women in the sample relied on their daughters heavily for daily caregiving.
The women also described their grandchildren as sources of support and happiness, by making them feel wanted and loved when the children visited. One woman described:. Well, I supposed to be living by myself. But my children and my grandkids… I never live alone.
I live with all my. I be around somebody all of the time.
They come to visit. Siblings and cousins were also cited as helping with transportation and being someone the women could talk to about important things. Other women reported having a couple of good friends they could talk to, most of whom were women.
Two women reported platonic relationships with male friends. Several women described being socially isolated, with limited support.
Most lived by themselves, and a few said they had no one, only one or two people, or only paid caregivers with whom they could talk. My daughter, I guess, she lives with me. All 15 women reported limiting their social interactions largely because they did not want others to find out they had HIV infection. Only one woman reported disclosing to most of the people in her life, largely because a family member told others she had HIV without her permission. All of the women in the study said that they did not want certain people or, for some women, anyone in their personal lives, to know about their HIV status.
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As one woman explained. You know, I used to cook for people and stuff. I stopped doing that. Just as far as other people are concerned, I just try to stay my distance. The main reason women gave for not disclosing their HIV status to others was to prevent people from fearing contracting HIV through casual contact with them. As one woman described.
Some women justified their fears by relating instances in which people to whom they had not disclosed expressed fear of interacting with other HIV-infected people. Some women said their level of shame about having HIV, and subsequent social withdrawal, was higher because they were older. As one woman put it.
I guess that the older you get, the more isolated you feel because you kind of feel stupid. Like, how could I do … I should know better. I should know not to have unprotected sex at my age. I should know better. So, I think that is on top of just feeling alone, you feel dumb.
Only three women had a committed romantic partner with whom they were sexually active at the time of the interview, and one reported having an occasional sexual relationship with a male friend. Their descriptions of fulfillment and support derived from these relationships varied.
One woman enjoyed a particularly supportive relationship with her husband. When asked where she turned for support, she described:. My husband. Everyone needs a little of that. Many of the women who were not sexually active described the ending of past relationships due to choice, abandonment, or partner death. Of women who were in relationships at the time of HIV diagnosis, only one said she had remained in the relationship with the man who infected her.
Somebody I could go out to eat with, go bowling, go to the zoo. Another woman described how the romantic and sexual aspects of her relationship with an HIV-uninfected partner decreased gradually after her diagnosis until she considered him to be more of a roommate. Eventually, she chose to stop having sex with him because they were not married and she wanted to feel closer to God. But, really, we only stopped having sex a few months ago. He goes one way and I go mine. The women were reluctant to enter into new relationships and listed several reasons for this disinclination, including fear of infecting others, fear of being rejected, lack of available men, and low prioritization Mature women who want sex Faith North Carolina having sexual intercourse.
And I told him in the letter. I be feeling funny like that. We friends but I still be feeling funny though. He told me we could and I happen to have [a condom] with me at the time. Other women feared the stigma they would face if they disclosed their status to a new partner. And, I think it would be a standoffish kind of thing.
The women who were not currently in a sexual relationship implied that their sexual desires were not great enough to lead them to pursue one. One woman implied that her low level of sexual desire could be attributed to menopause:. I could take it or leave it.