Stigma and Psychological Well-being Among Older Adults With HIV: The Impact of Spirituality and Integrative Health Approaches.

Abstract

The National Institutes of Health calls for research that explores what it means to age optimally with HIV/AIDS as half of the U.S. people with HIV are aged 50 or older. This study applied the stress process model to examine the association between HIV stigma and psychological well-being and mediating resources (i.e., spirituality and complementary and integrative health [CIH]) approaches) in older adults with HIV. Using data from the Research on Older Adults with HIV (ROAH) study, structural equation modeling was used to estimate these relationships within a latent variable model. Namely, a direct negative association between HIV stigma and psychological well-being was hypothesized that would be mediated by spirituality and/or CIH use. The analyses showed that the model fits the data well [χ2 (137, N = 914) = 561.44, p = .000; comparative fit index = .964; root mean square error of approximation = .058, 95% confidence interval = .053 to .063]. All observed variables significantly loaded on their latent factor, and all paths were significant. Results indicated that spirituality and CIH use significantly mediated the negative association between HIV stigma and psychological well-being. Findings highlight the importance of spiritual and CIH interventions for older adults with HIV/AIDS. Practice recommendations are provided at the micro- and mesolevel.