Ageing with HIV
Applying Fraser’s inequalities framework to our UK-based HIV and Later Life (HALL) study, we show that, for the growing population of older people living with HIV (PLWH), HIV intersects with ethnicity, sex, sexuality, stigma, and ageism to produce bivalent identities. These shape their experience of ageing with HIV and intersect with economic factors, the social status order, and statutory policy to subject them to socio-economic and cultural injustices only roughly captured by Fraser’s three domains of inequality. Under recognition, the stigmatisation of HIV and its exacerbation by normative ageist expectations threaten social relationships. Under resources, older PLWH’s disproportionate financial disadvantage, linked to interrupted work histories, uncertain migration status, and recent changes to benefits on which PLWH are disproportionately reliant and whose new criteria disadvantage them, make access to support from others living with HIV and from HIV organisations even more essential for mental health and well-being. Finally, under representation, stigma and homophobia in care settings may undermine the quality of long-term care, and defunding of HIV organisations and welfare benefit changes via neo-liberal policies and austerity measures create political disenfranchisement and barriers to social participation. Thus, Fraser’s clear-cut domains imperfectly capture factors undermining underlying causes of older PLWH’s disadvantage: HIV-specific supports (resources) established to compensate for difficulties emanating from Fraser’s recognition and resources domains are increasingly threatened by agents operating within Fraser’s representation domain. Our conclusion considers other sources of older PLWH’s under-representation: their waning participation in activism and advocacy on their own behalf, and inadequate attention by non-HIV organisations.