Antiretroviral therapy and aging as resources for managing and resisting HIV-related stigma in rural South Africa

SSM Qual Res Health. 2022 Dec:2:100148. doi: 10.1016/j.ssmqr.2022.100148. Epub 2022 Aug 6.

Abstract

The widespread roll-out of antiretroviral therapy (ART) in Africa has contributed to a large population of adults aging with HIV. However, little is known about how HIV-related stigma interacts with aging in the ART era. This study uses in-depth interviews with middle-aged and older South Africans living with HIV to explore stigma-related experiences and response strategies. Participants describe a persistence of stigma which requires the deployment of a range of common and age-based stigma management and resistance strategies. We find that participants minimize their exposure to stigma through selective disclosure of their HIV status; neutralize HIV-related stigma through comparisons to chronic illnesses common among older adults, and deflect stigma through asserting an ART-adherent identity and othering younger non-adherent adults. Overall, our study highlights the roles of ART and aging as resources for managing and resisting HIV-related stigma.

Keywords: ART; Aging; HIV; South Africa; Stigma.