Social Vulnerability, Perceived Stigma, and Multidimensional Frailty Among Older People Living with HIV: A Structural Equation Modeling Analysis.

Abstract

This study explored the relationships among social vulnerability, perceived stigma, and multidimensional frailty among older people living with HIV (PWH) and examined the mediating roles of loneliness and perceived stigma in these relationships. A cross-sectional study was performed among older PWH, between December 2022 and October 2023. Data on sociodemographic characteristics, perceived stigma, social vulnerability (including social isolation and loneliness), and multidimensional frailty were collected and analyzed. Social vulnerability and perceived stigma were significantly positively correlated with multidimensional frailty. Social isolation directly affected multidimensional frailty (β = .239, p < .001) and had an indirect influence (β = .331, p < .001) through the mediating effects of loneliness and perceived stigma. Social isolation among older PWH is associated with multidimensional frailty, which is mediated by loneliness and perceived stigma. On the basis of these findings, interventions aimed at reducing social vulnerability and perceived stigma may help prevent or alleviate frailty among older PWH, thereby improving their overall well-being. The results highlight the critical need to assess loneliness and perceived stigma among socially isolated older PWH. Interventions should prioritize stigma reduction and foster meaningful social connections to mitigate their compounding effects on frailty progression.