Loneliness and social isolation
Older adults with HIV (OAH) are characterized as having high levels of loneliness. It is certainly higher than in older adults in general. Some people may choose to be alone – the typical “loner”. But for most OAH who exhibit loneliness it is not by choice but circumstances. To escape the toxic effects of AIDS stigma and the accompanying feelings of rejection, many people with HIV, including OAH have opted to isolate and avoid the impact of AIDS stigma and the fear of rejection and judgment by others. This self-imposed isolation can be an intentional withdrawal, a self-defense. Since many OAH have been disenfranchised by family and friends and have not established new relationships, the isolation causes dysfunction. They lose the skills to interact with other people and in the process, they internalize the stigma they are trying to escape. They begin to believe the myths that underlie the stigma. Depression itself can magnify the isolation if it is not managed. And the isolation can magnify the depression creating a down spiral. In fact a study has shown that loneliness has a high association with depression. Isolation also impedes the need to exercise as well as eat healthy food. Isolation often causes a sedentary lifestyle that contributes to the risk for developing and exacerbating the comorbidities associated with aging. Many of these older adults lack the basic social supports that spouses and partners and children provide.
Older adults in their 7th through 9th decades of life are typically at risk for loneliness when they lose the intimacy or commitment to family or friends. This usually occurs when they lose spouses, partners and friends, or become socially isolated due to life circumstances which include deteriorating health and frailty. Higher levels of loneliness are correlated with poor treatment outcomes for people living with chronic illnesses, especially heart disease and cancers.
The powerful role that stigma plays in fostering both social isolation and the loneliness that results among people living with HIV, both old and young alike, cannot be ignored.
Recently the US Surgeon General warned that Americans are “facing an epidemic of loneliness and social isolation.” The primary unmet need of older adults with HIV is socialization. The older adult with HIV expresses this consistently in multiple research studies and reports. The benefits of socialization are significant and can affect every part of a person’s health and care management. So – how does one create situations that provide socialization and thereby combat perceived loneliness? One size does not fit all. Creating events, venues, programs that promote socialization should be many and varied. Look to your AIDS Service Organizations, or other CBOs (Community Based Organizations) who should be providing opportunities to socialize. This is especially true during holiday seasons. If they are not – you need to ask – why not? But achieving socialization is not going to happen simply by putting people together.
Socialization, that human need to be interconnected, is part of our humanity, is activated when we do something for others. Being a friend is a giving process. Volunteerism is a clear “giving” process. Contributing to a group activity – sports comes to mind or even games. One of the effects of persistent loneliness is the withdrawal from one’s community. As that process continues and persists there is an increase in the person’s becoming increasingly egocentric. Seeing life through the lens of loneliness is a cycle that must be broken.
The Community Map on this Resource site is aimed at sharing with the larger HIV community what types of activity and interventions are being offered and developed to address the issue of social isolation. By sharing these efforts, others can also use those ideas, or modify them for their community, or become a catalyst for new programs.