Graduation Year

2021

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Dean's Office

Major Professor

Nancy Romero-Daza, Ph.D.

Committee Member

Rebecca Zarger, Ph.D.

Committee Member

Jason Sokolovsky, Ph.D.

Committee Member

Debra Dobbs, Ph.D.

Committee Member

Tamara Baker, Ph.D.

Keywords

epidemic, greying, Life course, Social Death

Abstract

Today, adults aged fifty and older are the fastest growing segment of those living with HIV/AIDS. Yet, little remains known about the socio-cultural consequences of aging with HIV, and whether social and health care infrastructure is currently adequate to meet the unique needs of this population. Particularly understudied are older minority men aging with HIV. Drawing from an anthropological life course perspective and tenets of Becker’s (1997) framework on life disruption and reorganization, this dissertation research investigated older, Black males’ experiences of disruption and reorganization from aging with HIV in the present landscape of HIV care.This research comprised of the following specific aims: (1) Identify older, Black American males’ challenges in aging with HIV; (2) Highlight older, Black American males’ varying life course perspectives and views on social death; (3) Describe how experiences of aging with HIV map onto Becker’s (1997) framework of disruption and reorganization; and (4) Detail service providers perspectives on meeting the diverse social and health care needs of old, Black American males aging with HIV. This dissertation research took place in Hillsborough County, FL over a period of five years from 2016-2021. The data consisted of brief open-ended interviews with older, Black American men (N=35) living with HIV, a subset (N=6) of which was chosen for in-depth life course interviews. Six key informants (N=6) from local aids organizations (ASOs), community-based organizations (CBOs) and the healthcare sector were solicited for participation in this project.

Qualitative analysis from the 35 semi-structured interviews found that older, Black American males living with HIV faced significant health and mental health challenges as they age with HIV. In-depth interviews with the subsample of participants revealed experiences of aging with HIV that both agreed and disagreed with Becker’s (1997) framework of life disruption and reorganization and exposed how ageism, HIV stigma, and loss of social support and community membership led to their “social death”. Last, perceptions of HIV service providers exposed the need for greater patient support in their chronic HIV disease management; the need to address the cultural and structural stigma surrounding mental health pronounced in men; and the need to bolster our HIV response by investing in infrastructure culturally competent staff and resources so that providers are better equipped to address the diverse needs of this burgeoning population.

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