Influences of Gender-Based Stigma on HIV Prevention and Care Among Older Women: A Scoping Review.

Abstract: Older women living with HIV are uniquely situated at multiple marginalized intersections because of their gender, age, and HIV status. However, research into how gender-based stigma (GBS) affects HIV prevention and care for older women is sparse. We conducted a scoping review to explore the relationship between GBS and HIV-related psychosocial, behavioral, and well-being outcomes among older women. Our systematic search yielded 25 articles describing 22 unique studies. We identified five main themes highlighting how GBS exists at individual, interpersonal, and societal levels to adversely affect HIV prevention and treatment among older women: (a) relationship power, safe sex practices, and intimate partner violence; (b) stigma, discrimination, and harmful stereotypes; (c) quality of care; (d) caregiving roles and responsibilities; and (e) psychological and physiological manifestations. Outstanding questions remain on best methods for measuring and conceptualizing GBS in HIV research and ways to translate research findings to public health practice.