Previous research on HIV stigma and the use of spirituality by people living with HIV/AIDS is scarce. Moreover, the research with older Black men who have sex with men (BMSM) is scant. The focus of this qualitative transcendental phenomenological study was to examine the lived experiences of BMSM living with HIV aged 50 and older with encounters of HIV stigma on the use of spirituality. The research questions were designed to explore the lived experiences of aging, HIV stigma, and spirituality. Conceptually, this study was framed within the minority stress theory and the HIV stigma framework. Data were collected through in-depth individual interviews, which provided detailed descriptions of the participants' experiences and created a basis for analysis. Ten participants from an HIV service organization in the Mid-Atlantic United States were selected for participation. Semi-structured interviews were digitally recorded, and data were coded and thematized using a modified vam Kaam data analysis method, which lead to the disclosure of 8 critical themes that illuminated the participants' lived experiences of living with HIV, aging, stigma, and spirituality. Older BMSM identified stigma as a stressor that reinforced the use of their spirituality. The results of this study may provide social workers, community organizations, and policymakers with data that inform a deeper understanding of the challenges older BMSM face due to HIV stigma. This study contributes to positive social change by providing practical information for social workers to inform intervention strategies that might reduce stigma and increase coping resources.

Although the negative impact of HIV stigma is well documented, a gap exists in exploration of constructs that mediate the relationship between HIV stigma and psychological QOL (PQOL). Self-esteem is often conceptualized as a protective factor. We used PLS-SEM to explore the relationships between HIV stigma, PQOL and self-esteem, where PQOL and self-esteem are latent constructs represented by direct observations. Our hypotheses were supported - stigma is negatively related to self-esteem (as measured by self-blame, forgiveness of self, acceptance without judgment and self-esteem), self-esteem is positively related to PQOL (as measured by depression, mental health, QOL and perceived stress) and when the two aforementioned relationships are controlled for, a previously significant relation between stigma and PQOL changes its value significantly. These findings have implications for interventions designed to mitigate the negative psychosocial effects of stigma in PLH.

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