Abstract
Prevalence of HIV after age 50 is considerable, especially in southern Africa. Negative social constructions of HIV in older age, and the health consequences of ageing with the virus, mean that having HIV presents a challenge for many people's roles and social memberships, threatening to disrupt their sense of self. Using constructivist grounded theory and qualitative data from rural Malawi, this paper describes how older men and women deal with these identity challenges. Drawing on a symbolic interactionist framework, it uses identity control theory to explore how the study's participants presented their post‐diagnosis behaviours in ways that maintained their most significant pre‐diagnosis identities as ‘adults’, a label they gave to the core identity of being a person who belongs in the social world. Considering the processes through which older people with HIV navigated challenges to their identities in light of the intersectional influences of HIV and age‐related stigma and illness, provides insight into how older people might experience HIV, as well as informing theoretical understandings of identity formation and maintenance in light of chronic and/or stigmatising illness more broadly.
Highlights
For more than 30 years, Human Immunodeficiency Virus (HIV) has implied a social identity, rather than just an illness (Sontag 1988)
In the dominant global imagination, the risky sexual behaviours and outcomes associated with HIV are not those associated with older age
In rural Malawi where supply of ART is limited, HIV remains associated with sex, illness and death
Summary
For more than 30 years, Human Immunodeficiency Virus (HIV) has implied a social identity, rather than just an illness (Sontag 1988). The negative social construction of HIV and the health consequences of the virus mean that HIV changes older adults’ lives It changes how they manage their daily lives, their relationships and their plans for the future. Consideration of the effect of HIV on the self has typically focused on younger adults’ experiences In this regard, identity work is expected to include identifying and accepting which aspects of the self have been lost through experience of diagnosis and illness, which can be reclaimed and which aspects have been added, so that the self is recreated, or at least refined, in such a way as to ‘incorporate’ HIV (Baumgartner 2007, Russell and Seeley 2010, Seeley et al 2012, Tewksbury and McGaughey 1998). Continuing the tradition of applying an interactionist framework to understand the self, I draw on identity control theory (Burke 2007) to unpack the processes by which participants (re)constructed positive identities and avoided ‘spoiled’ identities
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