African American Older Adults Living with HIV: Exploring Stress, Stigma, and Engagement in HIV Care.

Limited information is available about factors that affect care engagement among African American older people living with HIV (OPLWH), despite the fact that this is the racial/ethnic group most disproportionally living with HIV/AIDS in the United States. The present mixed methods study examined the experiences of stress, HIV-related stigma, and engagement in care in a sample of 35 African American OPLWH. Quantitative methods measured global stress, HIV-stigma, and engagement in care, while in-depth qualitative interviews captured the lived experiences of HIV care engagement. Engagement in care was moderately correlated with overall stigma (r = -0.33, p = .05) and perceived stress (r = -0.42, p = .01). Qualitative interviews revealed that stigma was not the most significant stressor in the elders' lives, but instead a present and underlying force that was overshadowed by everyday life stressors that affected care engagement. Recommendations include that a retention specialist work alongside health care providers to increase engagement.