HIV-related shame and health-related quality of life among older, HIV-positive adults

Abstract

This study investigated how HIV-related shame is associated with health-related quality of life (HRQoL) in older people living with HIV (PLHIV). Structural equation modeling tested whether HIV-related shame was associated with three dimensions of HRQoL (physical, emotional, and social well-being) and whether there were significant indirect associations of HIV-related shame with the three HRQoL dimensions via depression and loneliness in a sample of 299 PLHIV ≥50 years old. Results showed that depression and loneliness were key mechanisms, with depression at least partially accounting for the association between HIV-related shame and both emotional and physical well-being, respectively, and loneliness accounting for the association between HIV-related shame and social well-being. HIV-related shame appears to be an important correlate of HRQoL in older PLHIV and may provide a promising leveraging point by which to improve HRQoL in older PLHIV.

Keywords: Aging; Depression; HIV/AIDS; Loneliness; Quality of life; Shame.

Fig. 1

Variables in the figure represent latent variables with standardized coefficients. Given that each factor was unidimensional, indicator variables were randomly assigned to parcels for each latent variable to reduce model complexity. The intermediary and outcome variables were regressed on the following covariates: age, gender (male as reference group), location (New York as reference group, Ohio as non-reference group), race/ethnicity (Blacks as reference group), highest level of education achieved (less than high school diploma as reference group), and income ($0–10,000 as reference group). *p < 0.05; **p < 0.01; ***p < 0.001