Intersecting stigmas: the impact of ageism and HIV discrimination on care experiences of older adults in Uganda

Abstract

The population of older persons living with HIV is growing globally, yet their lived experiences - particularly regarding stigma and age-based discrimination - remain insufficiently explored. This study examines how intersecting stigmas of HIV and ageism shape the care experiences of older adults accessing HIV care in Uganda. Using a qualitative approach, we conducted in-depth interviews with 30 older persons (aged 50 and above) on antiretroviral therapy in urban and rural settings and 9 key informant interviews between April and December 2024. Guided by intersectionality theory, our thematic analysis revealed that participants experienced a "double burden" of stigma, stemming from both HIV-related discrimination and societal ageism, which created significant barriers to accessing care and undermined trust in healthcare providers. Stigmatizing perceptions from healthcare workers and community members often left older persons feeling excluded, judged and discouraged from seeking support. These findings highlight the need for interventions that address the compounded stigma faced by older persons living with HIV. Integrating age-sensitive approaches into HIV care, implementing stigma reduction initiatives, and bridging geriatric and HIV services are essential steps to improve health outcomes and quality of life for this marginalized population.