Beyond Neighbors: Social Capital and Self-Empowerment Among Older Adults Diagnosed with HIV Late.

Older people with HIV (those aged ≥ 50 years) are living longer due to advances in HIV and chronic disease treatment. Social capital is often associated with better HIV clinical outcomes, such as high adherence to medication rates. However, this group is experiencing disrupted social connectedness related to shrinking social networks, which may impact their quality of life. We conducted in-depth interviews via web conferencing among a sample of (n = 18) older people diagnosed with HIV late and attending care at two HIV clinics in New Haven, CT, between February 2020 and July 2021. We employed grounded theory and thematic analysis to identify themes related to the influence of social connectedness and social capital on HIV prevention and treatment. Participants' mean age was 59 years, 66% were Black or African American, 58% were male, and 67% had gross incomes < $25,000. Four themes were identified: (1) complexity in using neighbors as sources of social capital, (2) trusted forms of social capital, (3) neighborhood social capital and HIV stigma, and (4) self-empowerment as a response to limited social capital. While social capital may be available in one's social network or community, many felt that they needed additional skills in self-empowerment to obtain or leverage that social capital. Older people with HIV late need additional and unique support to manage their chronic disease along with their HIV care. Structural interventions that help build social connectedness in this population may contribute to a better quality of life.