“After 25 years of democracy we are still stigmatized and discriminated against…”: Health care experiences of HIV positive older black gay men in a township in South Africa

Abstract

Older gay black men living with HIV and AIDS have been and continue to be an invisible part of the research landscape in South Africa, with the focus being on the younger LGBTQI+ cohort. Furthermore, aging and health care concerns of this population are ‘swept under the carpet’ due to stigmatization and homophobia. This qualitative study explored the aging and health-care experiences of older gay black men in a selected township in the Cape Metropole, with the purpose of finding strategies to deal with their real life concerns. The first author utilized in-depth interviews with 15 participants, 10 of which were a sample of self-identified gay men, aged between 43-77 and drawn from a selected township in the Cape Metropole in South Africa. Five health professionals working at the local clinic were also interviewed. Interviews were audio-recorded in the language of the participants (isiXhosa) and transcribed verbatim. They were then translated from isiXhosa to English before a thematic analysis was undertaken. One of the key findings of the study was that health-care professionals, particularly nurses at a local clinic, are stigmatizing older black men who are living with HIV and AIDS. This is exacerbated by the rejection by their families and the death of their life partners which leads to isolation, loneliness and depression. Due to comorbidities, COVID-19 has led to some participants passing away. Training of health-care professionals should be prioritized by social workers and workshops should be held in the township to educate families of older LGBTQI+ people on their aging concerns.