Social support, social stigma, health, coping, and quality of life in older gay men with HIV

Abstract

With the advent of antiretroviral therapy, people with HIV/AIDS are living longer and managing their HIV infection as would an individual with any other chronic disease. As life expectancy increases, quality of life has progressed as an emerging issue for older adults with HIV/AIDS. A majority of people living with HIV in the U.S. are still gay men, who thus comprise a large portion of those who are growing older with the disease.

The aims of the descriptive, correlational study were to: (1) explore the relationships among age, race, socioeconomic status, health, social support, social stigma, coping, perceived health, and quality of life in older gay men with HIV; and (2) identify the best predictors of quality of life among the aforementioned variables, based on the theory of stress, appraisal, and coping by Lazarus and Folkman. A convenience sample of 60 older gay men (ages 50-65) with HIV participated in the study, of which 57% were white and 95% were taking HIV medications. Participants had, on average, been HIV positive for 17.9 years, reported 5.5 medical comorbidities other than HIV, and were taking 7.5 medications per day.

There were no differences in reported quality of life by race or socioeconomic status. Age, social support, perceived health, and problem-focused coping were significantly and positively correlated to quality of life, while medical comorbidities, social stigma (homonegativity, HIV stigma, ageism), and emotion-focused coping were all significantly and negatively associated with quality of life (p<0.01). When the significant variables were entered into regression analysis, medical comorbidities (-), emotional/informational support (+), HIV stigma (-), and emotion-focused coping (-) remained as significant predictors of quality of life, accounting for 64% of the variance in quality of life.

Future studies should examine the effects of social support, social stigma, and coping on quality of life in different populations of older gay men with HIV. Also, longitudinal studies are needed to determine potential cause and effect relationships among social support, social stigma, coping, and quality of life, prior to designing and testing interventions aimed at increasing health and quality of life in this population.

Keywords: aging, coping, gay, HIV, quality of life