Aging Women with Human Immunodeficiency Virus: A Narrative Analysis of Stigma

Aging Women with Human Immunodeficiency Virus: A Narrative Analysis of Stigma Seja Jackson, Ph.D. University of Connecticut, 2020 Over 50 % of people living with HIV are over age 50 (CDC, 2019a). Older women face unique challenges due to Human Immunodeficiency Virus (HIV) stigma, which leads to complications including late diagnosis and poorer outcomes. Despite the transition of HIV to a chronic disease, HIV stigma remains. In alignment with feminist principles, this author used Catherine Riessman’s (1993; 2008) method of thematic narrative analysis to illuminate the stories of aging women living with HIV. I interviewed 12 women over 50, aging with HIV. Their stories were individually analyzed and a meta-story of all stories was completed. Individual stories remained whole within the meta-story. This revealed five overarching themes: Persistent HIV Diagnosis Related Trauma: I Keep It All Bottled Up Inside, Self-silencing Disclosure: I Would Take It To My Grave, HIV Stigma: It Ain’t Goin’ Nowhere, Education: We Can End the Stigma, and Resilience Despite Challenges: I Kick Rocks To The HIV. This study helped close the knowledge gap and provided valuable insight for nursing about this population. Nurses can prevent HIV stigmatization and offer safe spaces for such women. They can be aware of ongoing depression. Nurses can support programs, funding, and legislation to end HIV stigma and include HIV care in their curricula. Nurse researchers can explore issues of importance for women aging with HIV. This study provided strong evidence for the ongoing HIV stigma status for women over 50 aging with HIV. The study demonstrated how nurses are critical in the struggle to end HIV stigma. Seja Jackson – University of Connecticut, 2020 Keywords: HIV, HIV stigma, stigma, older women, thematic narrative analysi

Simulating system dynamics of the HIV care continuum to achieve treatment as prevention.

The continuing HIV pandemic calls for broad, multi-sectoral responses that foster community control of local prevention and care services, with the goal of leveraging high quality treatment as a means of reducing HIV incidence. Service system improvements require stakeholder input from across the care continuum to identify gaps and to inform strategic plans that improve HIV service integration and delivery. System dynamics modeling offers a participatory research approach through which stakeholders learn about system complexity and about ways to achieve sustainable system-level improvements. Via an intensive group model building process with a task force of community stakeholders with diverse roles and responsibilities for HIV service implementation, delivery and surveillance, we designed and validated a multi-module system dynamics model of the HIV care continuum, in relation to local prevention and care service capacities. Multiple sources of data were used to calibrate the model for a three-county catchment area of central Connecticut. We feature a core module of the model for the purpose of illustrating its utility in understanding the dynamics of treatment as prevention at the community level. We also describe the methods used to validate the model and support its underlying assumptions to improve confidence in its use by stakeholders for systems understanding and decision making. The model's generalizability and implications of using it for future community-driven strategic planning and implementation efforts are discussed