My HIV Diagnosis Was a Blessing: It Saved My Life

Purpose: HIV remains at epidemic levels in the rural southern United States. Blacks are the ethnic group most affected by HIV with the rate of new HIV infections being 8 times that of Whites based on population size. The largest numbers of new HIV cases have been reported in the southern U.S. where Blacks represent a disproportional number of cases. Among Black adults and adolescents, men accounted for 70% of the estimated 20,900 new HIV infections that occurred in 2010. Among these men, sex with other men was the leading cause of infection followed by injection drug use. With the advent of effective antiretroviral medications, HIV has transitioned from a fatal disease to a manageable chronic condition. While Blacks continue to have a higher risk of dying from HIV than Whites, access to care and treatment is making it possible for them to live for decades. It is estimated that in the U.S., 50% of adults living with HIV are 50 years of age or older. Yet, there is limited data regarding how well Black men are aging with the disease. The overall purpose of this study was to explore the perceptions and experiences of older Black men living in the rural southeastern United States. This paper focuses on data that describes how HIV impacted the participants’ lives, how they care for themselves, and role of family in their life.

Methods: The study was conducted using a qualitative exploratory approach. Data were collected through face-to-face interviews with 35 HIV-infected Black men who were living in 5 rural or semi-rural areas in Georgia. Men were made aware of the study by staff of organizations/clinics that provided health services to individuals with HIV disease. The study inclusion criteria was being 50 years of age or older, male, Black, living with HIV for at least 5 years, and providing informed consent. Initially, the study was designed using a focus group format for data collection. Twenty-nine of the men participated in a focus group that was held in their area. Due to concerns about confidentially, 6 men agreed to participate in the study only if they could be interviewed privately. The researchers used a pre-developed interview guide that consisted of general open-end questions with probes to encourage men to expand or more fully describe their perceptions and experiences. Interviews were conducted by a member of the research team and audio-recorded. Men were also asked to complete a short demographic questionnaire.  The transcripts of the interviews were transcribed verbatim and analyzed using a constant comparative content analysis approach. The data from the focus groups were analyzed independent of the individual interviews. Results demonstrated that there was no difference in the descriptions of the men’s experiences and perceptions between the two groups so the data were combined for the final analysis.

Results: The men in the study ranged from 49 to 66 years of age (x = 55.6) and had lived with HIV for a mean of 20.9 years. Nine men had less than a high school education with 16 having completed technical school or at least some college. One participant had a doctorate.   Nineteen men reported an income of less than $10,000/year. Twenty-seven men lived alone while 7 are currently married/common law and one participant lived with a same sex partner. Two of the men were fully employed and six men being employed part-time. Seventeen men were receiving social security disability. Five men reported that they had been diagnosed with AIDS. 

Conclusion: Potentially quite different from what might have been expected, the majority of men reported they had what they needed and remained positive. These men were committed to going on with their lives and living healthy.  Many of the participants had a history of drug and/or alcohol abuse that they felt had resulted in their HIV infection. This supports epidemiological reports indicating that drug and alcohol use are frequent contributors to HIV infection among Black men. In many instances substance abuse is interrelated with poverty, lack of information about HIV risks, and stigma about HIV in the Black community.  Despite their past destructive behavior, our results show that family support remained strong. Many men reported their belief that HIV had changed their lives for the better. The men were looking forward to living for a long time and knew they would have to deal with other age-related illnesses as they continued to age. This study provides new insight into the lives of rural Black men, and expands our understanding of how these individuals are managing their HIV disease and why many return or remain in rural communities.