Navigating Life with HIV as an Older Adult in South African Communities: A Phenomenological Study

Abstract

The study explored how older adults experience an HIV diagnosis, deal with issues of stigma and disclosure, and navigate the healthcare system. Descriptive phenomenology was used to collect data from 20 older adults receiving antiretroviral treatment in health facilities in Gauteng Province, South Africa. Data analysis was inductive and followed the thematic approach. After diagnosis with HIV, the older adults experienced shock and disbelief, internalized their new reality of being HIV-positive, and found it difficult to disclose their HIV status. Stigma was embedded in their patterns of disclosure, and they chose not to disclose in order to manage stigma, protect their status, and maintain their privacy. Moreover, nondisclosure allowed them to achieve some normality in their lives without the fear of rejection. The older adults adopted various survival skills that aided them to accept their HIV status. Self-acceptance was important for the older adults who did not want to feel cheated out of life by the HIV diagnosis. The positive supportive attitudes of the healthcare professionals provided the much-needed support network for the older adults immediately after they had received their HIV test results. This was instrumental in their acceptance of their HIV status, their adherence to clinic visits, and their ability to live a healthy, positive life.

South Korean Nurses’ Experiences with Patient Care at a COVID-19-Designated Hospital: Growth after the Frontline Battle against an Infectious Disease Pandemic

“…The stigma experienced by adults with HIV had a negative effect on post-traumatic growth [37]. Similar to what was shown in the present study, adults with HIV experienced stigma, which affected their patterns of disclosure and eventually prevented them from disclosing their trauma experience (HIV-related challenges) [36]. However, self-disclosure is a vital factor in coping because it is the first strategy for managing stress from a trauma experience and the psychological preparation for post-traumatic growth [38].…”

“…No study has reported on the effect of stigma experienced by nurses who cared for COVID-19 patients on post-traumatic growth, but findings from previous research about stigma and post-traumatic growth of adults with HIV [36,37] are noteworthy. The stigma experienced by adults with HIV had a negative effect on post-traumatic growth [37].…”

Perceived Stigma as a Contextual Barrier to Early Uptake of HIV Testing, Treatment Initiation, and Disclosure; the Case of Patients Admitted with AIDS-Related Illness in a Rural Hospital in South Africa

“…The participants in this study did not disclose to family members who would pose the highest risk of negative emotional consequences. As a disclosure approach, selective disclosure is used, particularly by older people, to protect their status and guard against stigma [43]. We observed more disclosure to siblings and parents than to sexual partners.…”

“…People present late for HIV testing because of a poor uptake of HIV testing services, fear of a positive result, and a fear of stigma [26,33,41,42]. Among older persons, HIV testing is delayed due to low self-perceptions of the risk of HIV transmission and acquisition [43].…”

“…Since the children were old enough to understand the meaning of a HIV-positive diagnosis [14], they disclosed to receive appropriate support in case their condition worsened. Nondisclosure is used by PLHIV as a mechanism to maintain privacy, which allows them to achieve some normality without the fear of rejection and stigma [43,50].…”