Exploring Experiences and Perceptions of Older African American Males Aging With HIV in the Rural Southern United States

Abstract

The HIV (human immunodeficiency virus) epidemic in the United States remains a serious public health concern. Despite treatment and prevention efforts, approximately 50,000 new HIV cases are transmitted each year. Estimates indicate that 44% of all people diagnosed with HIV are living in the southern region of the United States. African Americans represent 13.2% of the United States population; however, 44% (19,540) of reported new HIV cases in 2014 were diagnosed within this ethnic group. The majority of cases were diagnosed in men (73%, 14,305). In the United States, it is estimated that 21% of adults living with HIV are 50 years or older. There exists limited data regarding how well African American men are aging with HIV disease. The purpose of this study was to explore the perceptions and experiences of older African American men living with HIV in rural Georgia. Data were collected from 35 older African American men living with HIV using focus groups and face-to-face personal interviews. Qualitative content analysis revealed six overlapping themes: (1) Stigma; (2) Doing Fine, Most of the Time; (3) Coping With Age-Related Diseases and HIV; (4) Self-Care; (5) Family Support; and (6) Access to Resources. The findings from this study provide new insights into the lives of rural HIV-infected African American men, expands our understanding of how they manage the disease, and why many return to or remain in rural communities.

Older African Americans and the HIV Care Continuum: A Systematic Review of the Literature, 2003–2018

“…35 were non-empirical studies or did not have a sample that met our inclusion criteria. The remaining 13 papers were reviewed for inclusion in the study: one on testing/diagnosis [33], seven on engagement in care [34][35][36][37][38][39][40], and five on ART prescription and adherence [41][42][43][44][45]. Table I outlines the manuscripts included in the review, and identifies and details the sample population, methodology, and key findings of each study.…”

“…Among the 13 papers (Table I), there were six qualitative studies (46%) [34][35][36][37][38]40]. Four studies (31%) were cross-sectional [33,[43][44][45], three of which used a mixed methods [33,[44][45] research design and one which used a telephone-based survey [43].…”

“…The remaining three studies (23%) were retrospective cohort studies [39,[41][42]. Six studies (46%) were conducted with samples that consisted of women only [33-35, 38, 44-45]; one study (8%) was conducted with a sample of only men [36]; and the remaining six studies (46%) were conducted with mixed gender samples [37,39,[41][42][43][44]. Five studies (38%) were conducted with samples consisting of 100% African American PLWH [34-36, 40, 45] and the remaining seven studies (54%) were conducted with mixed race samples that were majority African American [33,37,39,[41][42][43][44].…”

“…Six studies used qualitative interviews and focus groups to understand barriers and facilitators to engagement in the HIV care continuum [34][35][36][37][38]40]. Three studies used qualitative interviews and validated questionnaires to assess factors that facilitated and impeded engagement in the HIV care continuum [33,[44][45].…”

The Impact of Delivery in a Rural County on a Cohort of Women Living with HIV Infection and Their Infants

“…5 In 2013, over half of all new HIV diagnoses were made in the southern United States, where approximately a quarter of the population resides in rural areas. 6,7 In South Carolina, 34% of the total population and approximately 25% of people living with HIV reside in rural counties. 5 effects of rural residence on pregnancy outcomes among these women.…”