J Health Care Poor Underserved. 2020;31(1):265-286. doi: 10.1353/hpu.2020.0022.
Limited information is available about factors that affect care engagement among African American older people living with HIV (OPLWH), despite the fact that this is the racial/ethnic group most disproportionally living with HIV/AIDS in the United States. The present mixed methods study examined the experiences of stress, HIV-related stigma, and engagement in care in a sample of 35 African American OPLWH. Quantitative methods measured global stress, HIV-stigma, and engagement in care, while in-depth qualitative interviews captured the lived experiences of HIV care engagement. Engagement in care was moderately correlated with overall stigma (r = -0.33, p = .05) and perceived stress (r = -0.42, p = .01). Qualitative interviews revealed that stigma was not the most significant stressor in the elders' lives, but instead a present and underlying force that was overshadowed by everyday life stressors that affected care engagement. Recommendations include that a retention specialist work alongside health care providers to increase engagement.
关于影响美国生活着艾滋病毒的非裔美国老年人（OPLWH）参与护理的因素的信息有限，尽管这是在美国艾滋病毒/艾滋病感染率不成比例最高的种族/族裔群体。本混合方法研究调查了 35 名非裔美国 OPLWH 样本中的压力、与艾滋病毒相关的耻辱感和参与护理的经历。定量方法衡量了整体压力、艾滋病毒耻辱感和参与护理的情况，而深入的定性访谈则捕捉到了艾滋病毒护理参与的真实体验。参与护理与整体耻辱感（r = -0.33，p =.05）和感知压力（r = -0.42，p =.01）呈中度相关。定性访谈显示，耻辱感并不是老年人生活中的最大压力源，而是一种存在且潜在的力量，被影响护理参与的日常生活压力源所掩盖。建议包括让一名保留专家与医疗保健提供者合作，以提高参与度。
