No Man Is an Island: Resiliency Among Older African American Men Living with HIV.

Abstract

African American men face chronic illness earlier in life and earlier death due to higher severity of illness and poor control of chronic diseases than their white male counterparts. Preexposure and post-exposure prophylaxis PrEP and PREP have improved the odds of survival among those living with HIV. However, the anti-retroviral treatments, though effective, are only as effective as early prevention and detection and in cases where patients can adhere to treatment regimens. The mean age of participants (N = 11) was 56.44 (SD = 5.175, range = 47-63). The current study employs qualitative methodology to propose an ecosystems-driven intersectional model to identify resilience and the influence of personal, social, and societal forces shaping the lives of older African American men living with HIV. Findings determine stigma, community violence, and structural barriers to care as crucial stress areas. Participants discussed self-advocacy and family as constituent elements of resilience. Several implications for practice and research emerged. Practice must design and deploy assessment instruments to include exposure to racism and violence, including emotional and structural violence. Practice must include advocacy at the micro, meso, and macro levels. Assessment must also be self-reflexive. Organizational assessment should involve internal and structural reviews of barriers to meeting client preferences.