Unseen, Unheard, and Nearly Invisible: An Examination of Sexual Orientation and Spirituality’s Impact on Psychological Well-Being among Middle-Age and Older Black Men Living with HIV/AIDS: Implications for Caregiving

Middle age and older men with HIV infection/AIDS, having often lived with the condition longer, are more likely to confront the stress of managing more advanced HIV disease than their younger counterparts. Meanwhile, they also are more likely to have less social support and experience more distress than younger persons with HIV infection. Previous research has shown that spirituality has positive effects on both mental and physical health; however very few studies have examined the influence of spirituality and sexuality on mental-well-being in people with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Further, no studies have examined these variables specifically among middle-age and older Black men who are HIV positive or have AIDS-with caregiving implications. This study seeks to address those gaps with implications for caregiving. This article examines the relationship among spirituality, sexual orientation, and psychological well-being. Specifically, this research examines psychological well-being and the impact sexual orientation and spirituality have in predicting psychological well-being among 353 middle-age and older Black men living with HIV/AIDS, 49 years and over who are self-identified as homosexual/gay, bisexual, and heterosexual/straight. The theoretical framework utilized is the transactional model of stress and coping, which is a framework for evaluating coping with stressful life events. This research utilizes data from The Research on Older Adults with HIV (ROAH) study. The first comprehensive and in-depth study of this population, the ROAH study assessed a 1,000-person cohort in New York City, examining a comprehensive array of issues, including health status, stigma, depression, psychological well-being, sexual behavior, substance abuse, social networks, and spirituality. Bivariate tests along with multiple and hierarchical logistic regression was utilized to address research questions and hypotheses. The findings from this study imply that spirituality had a direct relationship with psychological well-being, and reveals the contribution of sexual orientation to psychological well-being and spirituality with middle –age and older adults living with HIV/AIDS. Implications for caregiving are also addressed.