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Psychosocial Mechanisms of Self-rated Successful Aging with HIV: A Structural Equation Model

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Abstract

This study tested a conceptual psychosocial model of self-rated successful aging (SRSA) with HIV. Our sample (n = 356) included older women living with HIV (OWLH): average age 56.5 years, 73% Black. SRSA was assessed using a research-based 10-point scale (higher scores = better outcomes). We conducted adjusted structural equation modeling. The global model included two latent variables—protective attributes (composite of positive psychosocial factors: resilience, personal mastery, optimism, spirituality) and psychological distress (composite of negative psychosocial factors: anxiety, depression, loneliness, internalized HIV-related stigma). The model showed good fit (χ2(58) = 76, p = 0.06; RMSEA = 0.03; CFI = 0.99). Increased protective attributes were associated with improved SRSA both directly and mediated by improved coping with stress. While psychological distress did not have a direct effect on SRSA, it was indirectly associated with worsened SRSA via diminished protective attributes and via decreased coping with stress. Findings suggest the need for interventions enhancing positive and mitigating negative psychosocial factors in OWLH.

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Data Availability

Access to individual-level data from the MACS/WIHS Combined Cohort Study Data (MWCCS) may be obtained upon review and approval of a MWCCS concept sheet. Links and instructions for online concept sheet submission are on the study website.

Code Availability

Code is available upon request.

Notes

  1. As an alternative, we also ran SEM with MLMV option, which accounts for missing data, and received similar results.

References

  1. Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and Dependent Areas, 2012. HIV Surveillance Report, 2012. 2014;24: Available at https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2012-vol-24.pdf. Accessed April 2020.

  2. Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and Dependent Areas, 2018. HIV Surveillance Report, 2018 (Updated). 2020;31: Available at https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2018-updated-vol-31.pdf. Accessed Jan 2021.

  3. Frazier EL, Sutton MY, Tie Y, Collison M, Do A. Clinical characteristics and outcomes among older women with HIV. J Womens Health. 2018;27(1):6–13.

    Article  Google Scholar 

  4. Rubtsova A, Wingood G, Ofotokun I, Gustafson D, Vance D, Sharma A, et al. Prevalence and correlates of self-rated successful aging among older women living with HIV. J Acquir Immune Defic Syndr. 2019;82(Suppl 2):S162–9.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Centers for Disease Control and Prevention. Diagnoses of HIV infection among adults aged 50 years and older in the United States and Dependent Areas, 2011–2016. HIV Surveillance Supplemental Report. 2018;23(5): Available at http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Accessed Feb 2019.

  6. Roger KS, Mignone J, Kirkland S. Social aspects of HIV/AIDS and aging: a thematic review. Can J Aging. 2013;32(3):298–306.

    Article  PubMed  Google Scholar 

  7. Rubtsova AA, Kempf M-C, Taylor T, Konkle-Parker D, Wingood GM, Holstad MM. Healthy aging in older women living with HIV Infection: a systematic review of psychosocial factors. Curr HIV/AIDS Rep. 2017;14(1):17–30.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Escota GV, O’Halloran JA, Powderly WG, Presti RM. Understanding mechanisms to promote successful aging in persons living with HIV. Int J Infect Dis. 2018;66:56–64.

    Article  PubMed  Google Scholar 

  9. Collins LF, Sheth AN, Mehta CC, Naggie S, Golub ET, Anastos K, et al. The prevalence and burden of non-AIDS comorbidities among women living with or at-risk for HIV infection in the United States. Clin Infect Dis. 2021;72(8):1301–1311.

    Article  PubMed  Google Scholar 

  10. Rubin LH, Maki PM. Neurocognitive complications of HIV infection in women: insights from the WIHS Cohort. Curr Topics Behav Neurosci. 2019. https://doi.org/10.1007/7854_2019_101.

    Article  Google Scholar 

  11. Kong AM, Pozen A, Anastos K, Kelvin EA, Nash D. Non-HIV comorbid conditions and polypharmacy among people living with HIV age 65 or older compared with HIV-negative individuals age 65 or older in the United States: a retrospective claims-based analysis. AIDS Patient Care STDS. 2019;33(3):93–103.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Erlandson KM, Plankey MW, Springer G, Cohen HS, Cox C, Hoffman HJ, et al. Fall frequency and associated factors among men and women with or at risk for HIV infection. HIV Med. 2016;17(10):740–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Levett TJ, Cresswell FV, Malik MA, Fisher M, Wright J. Systematic review of prevalence and predictors of frailty in individuals with human immunodeficiency virus. J Am Geriatr Soc. 2016;64(5):1006–14.

    Article  PubMed  Google Scholar 

  14. Marcus JL, Chao CR, Leyden WA, Xu L, Quesenberry CP Jr, Klein DB, et al. Narrowing the gap in life expectancy between HIV-infected and HIV-uninfected individuals with access to care. J Acquir Immune Defic Syndr. 2016;73(1):39–46.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Depp C, Vahia IV, Jeste D. Successful aging: focus on cognitive and emotional health. Annu Rev Clin Psychol. 2010;6:527–50.

    Article  PubMed  Google Scholar 

  16. Baltes PB, Baltes MM. Psychosocial perspectives on successful aging: the model of selective optimization with compensation. In: Baltes PB, Baltes MM, editors. Successful aging: perspectives from the behavioral sciences. Cambridge: Cambridge University Press; 1990.

    Chapter  Google Scholar 

  17. Kahana E, Kahana B. Successful aging among people with HIV/AIDS. J Clin Epidemiol. 2001;54(Suppl 1):S53–6.

    Article  PubMed  Google Scholar 

  18. Rowe JW, Kahn RL. Successful aging. Gerontologist. 1997;37(4):433–40.

    Article  CAS  PubMed  Google Scholar 

  19. Emlet CA, Harris L, Furlotte C, Brennan DJ, Pierpaoli CM. ‘I’m happy in my life now, I’m a positive person’: approaches to successful ageing in older adults living with HIV in Ontario, Canada. Ageing Soc. 2017;37(10):2128–51.

    Article  Google Scholar 

  20. Fazeli PL, Montoya JL, McDavid CN, Moore DJ. Older HIV+ and HIV- adults provide similar definitions of successful aging: a mixed-methods examination. Gerontologist. 2018;60(3):385–95.

    Article  PubMed Central  Google Scholar 

  21. Solomon P, Letts L, O’Brien KK, Nixon S, Baxter L, Gervais N. “I’m still here, I’m still alive”: understanding successful aging in the context of HIV. Int J STD AIDS. 2018;29(2):172–7.

    Article  PubMed  Google Scholar 

  22. Moore RC, Moore DJ, Thompson WK, Vahia IV, Grant I, Jeste DV. A case-controlled study of successful aging in older HIV-infected adults. J Clin Psychiatry. 2013;74(5):e417–23.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Montross LP, Depp C, Daly J, Reichstadt J, Golshan S, Moore D, et al. Correlates of self-rated successful aging among community-dwelling older adults. Am J Geriatr Psychiatry. 2006;14(1):43–51.

    Article  PubMed  Google Scholar 

  24. Jeste DV, Savla GN, Thompson WK, Vahia IV, Glorioso DK, Martin AS, et al. Association between older age and more successful aging: critical role of resilience and depression. Am J Psychiatry. 2013;170(2):188–96.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Jeste DV, Depp CA, Vahia IV. Successful cognitive and emotional aging. World Psychiatry. 2010;9(2):78–84.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Diener E, Chan MY. Happy people live longer: subjective well-being contributes to health and longevity. Appl Psychol Health Well Being. 2011;3(1):1–43.

    Article  Google Scholar 

  27. Moore RC, Eyler LT, Mausbach BT, Zlatar ZZ, Thompson WK, Peavy G, et al. Complex interplay between health and successful aging: role of perceived stress, resilience, and social support. Am J Geriatr Psychiatry. 2015;23(6):622–32.

    Article  PubMed  Google Scholar 

  28. Vahia IV, Thompson WK, Depp CA, Allison M, Jeste DV. Developing a dimensional model for successful cognitive and emotional aging. Int Psychogeriatr. 2012;24(4):515–23.

    Article  PubMed  Google Scholar 

  29. Arvidsdotter T, Marklund B, Kylen S, Taft C, Ekman I. Understanding persons with psychological distress in primary health care. Scand J Caring Sci. 2016;30(4):687–94.

    Article  PubMed  Google Scholar 

  30. Vance DE, Burrage J Jr, Couch A, Raper J. Promoting successful aging with HIV through hardiness: implications for nursing practice and research. J Gerontol Nurs. 2008;34(6):22–9.

    Article  PubMed  Google Scholar 

  31. Vance DE, Struzick TC, Raper JL. Biopsychosocial benefits of spirituality in adults aging with HIV: implications for nursing practice and research. J Holist Nurs. 2008;26(2):119–25.

    Article  PubMed  Google Scholar 

  32. Ironson G, Hayward H. Do positive psychosocial factors predict disease progression in HIV-1? A review of the evidence. Psychosom Med. 2008;70(5):546–54.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Folkman S, Moskowitz JT. Coping: pitfalls and promise. Annu Rev Psychol. 2004;55:745–74.

    Article  PubMed  Google Scholar 

  34. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer Publishing; 1984.

    Google Scholar 

  35. Blashill AJ, Perry N, Safren SA. Mental health: a focus on stress, coping, and mental illness as it relates to treatment retention, adherence, and other health outcomes. Curr HIV/AIDS Rep. 2011;8(4):215–22.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Bacon MC, von Wyl V, Alden C, Sharp G, Robison E, Hessol N, et al. The Women’s Interagency HIV Study: an observational cohort brings clinical sciences to the bench. Clin Diagn Lab Immunol. 2005;12(9):1013–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Adimora AA, Ramirez C, Benning L, Greenblatt RM, Kempf MC, Tien PC, et al. Cohort profile: the Women’s Interagency HIV Study (WIHS). Int J Epidemiol. 2018;47(2):393–4.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Barkan SE, Melnik SL, Preston-Martin S, Weber K, Kalish LA, Miotti P, et al. The Women’s Interagency HIV Study. Epidemiology. 1998;9(2):117–25.

    Article  CAS  PubMed  Google Scholar 

  39. Gwee X, Nyunt MS, Kua EH, Jeste DV, Kumar R, Ng TP. Reliability and validity of a self-rated analogue scale for global measure of successful aging. Am J Geriatr Psychiatry. 2014;22(8):829–37.

    Article  PubMed  Google Scholar 

  40. Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76–82.

    Article  PubMed  Google Scholar 

  41. Pearlin LI, Schooler C. The structure of coping. J Health Soc Behav. 1978;19:2–21.

    Article  CAS  PubMed  Google Scholar 

  42. Fetzer Insitute; National Institute on Aging Working Group. Multidimensional measurement of religiousness, spirituality for use in health research. A report of a National Working Group. Supported by the Fetzer Institute in Collaboration with the National Institute on Aging. Kalamazoo, MI: Fetzer Institute; 2003 (1999).

  43. Radloff LS. The CES-D scale: a self report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.

    Article  Google Scholar 

  44. Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.

    Article  PubMed  Google Scholar 

  45. Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT. A short scale for measuring loneliness in large surveys: results from two population-based studies. Res Aging. 2004;26(6):655–72.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Williams DR, Gonzalez HM, Williams S, Mohammed SA, Moomal H, Stein DJ. Perceived discrimination, race and health in South Africa. Soc Sci Med. 2008;67(3):441–52.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Sternthal MJ, Slopen N, Williams DR. Racial disparities in health. Du Bois Rev. 2011;8(1):95–113.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001;24:518–29.

    Article  CAS  PubMed  Google Scholar 

  49. Turan B, Smith W, Cohen MH, Wilson TE, Adimora AA, Merenstein D, et al. Mechanisms for the negative effects of internalized HIV-related stigma on antiretroviral therapy adherence in women: the mediating roles of social isolation and depression. J Acquir Immune Defic Syndr. 2016;72(2):198–205.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Boodram B, Plankey MW, Cox C, Tien PC, Cohen MH, Anastos K, et al. Prevalence and correlates of elevated body mass index among HIV-positive and HIV-negative women in the Women’s Interagency HIV Study. AIDS Patient Care STDS. 2009;23(12):1009–16.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Estrella MM, Parekh RS, Abraham A, Astor BC, Szczech LA, Anastos K, et al. The impact of kidney function at highly active antiretroviral therapy initiation on mortality in HIV-infected women. J Acquir Immune Defic Syndr. 2010;55(2):217–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Khalsa A, Karim R, Mack WJ, Minkoff H, Cohen M, Young M, et al. Correlates of prevalent hypertension in a large cohort of HIV-infected women: Women’s Interagency HIV Study. AIDS. 2007;21(18):2539–41.

    Article  PubMed  Google Scholar 

  53. Tien PC, Schneider MF, Cox C, Karim R, Cohen M, Sharma A, et al. Association of HIV infection with incident diabetes mellitus: impact of using hemoglobin A1C as a criterion for diabetes. J Acquir Immune Defic Syndr. 2012;61(3):334–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Sharma A, Vance DE, Hoover DR, Shi Q, Yin MT, Holman S, et al. Impaired cognition predicts falls among women with and without HIV infection. J Acquir Immune Defic Syndr. 2020;83(3):301–9.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Vance DE, Rubin LH, Valcour V, Waldrop-Valverde D, Maki PM. Aging and neurocognitive functioning in HIV-infected women: a review of the literature involving the Women’s Interagency HIV Study. Curr HIV/AIDS Rep. 2016;13(6):399–411.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Rubin LH, Maki PM, Springer G, Benning L, Anastos K, Gustafson D, et al. Cognitive trajectories over 4 years among HIV-infected women with optimal viral suppression. Neurology. 2017;89(15):1594–603.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Haardörfer R. Taking quantitative data analysis out of the positivist era: calling for theory-driven data-informed analysis. Health Educ Behav. 2019;46(4):537–40.

    Article  PubMed  Google Scholar 

  58. Acock AC. Discovering structural equation modeling using Stata. Revised. College Stattion, TX: Stata Press; 2013.

    Google Scholar 

  59. Hughes DJ, Kratsiotis IK, Niven K, Holman D. Personality traits and emotion regulation: a targeted review and recommendations. Emotion. 2020;20(1):63–7.

    Article  PubMed  Google Scholar 

  60. Segerstrom SC, Smith GT. Personality and coping: individual differences in responses to emotion. Annu Rev Psychol. 2019;70:651–71.

    Article  PubMed  Google Scholar 

  61. Carver CS, Connor-Smith J. Personality and coping. Annu Rev Psychol. 2010;61:679–704.

    Article  PubMed  Google Scholar 

  62. Emlet CA, Shiu C, Kim HJ, Fredriksen-Goldsen K. Bouncing back: resilience and mastery among HIV-positive older gay and bisexual men. Gerontologist. 2017;57(suppl 1):S40–9.

    Article  PubMed  PubMed Central  Google Scholar 

  63. High KP, Brennan-Ing M, Clifford DB, Cohen MH, Currier J, Deeks SG, et al. HIV and aging: state of knowledge and areas of critical need for research: a report to the NIH Office of AIDS Research by the HIV and Aging Working Group. J Acquir Immune Defic Syndr. 2012;60(Suppl 1):S1-18.

    Article  CAS  PubMed  Google Scholar 

  64. Degroote S, Vogelaers D, Vandijck DM. What determines health-related quality of life among people living with HIV: an updated review of the literature. Arch Public Health. 2014;72(1):40.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Singh HK, Del Carmen T, Freeman R, Glesby MJ, Siegler EL. From one syndrome to many: incorporating geriatric consultation into HIV care. Clin Infect Dis. 2017;65(3):501–6.

    Article  PubMed  Google Scholar 

  66. Siegler EL, Burchett CO, Glesby MJ. Older people with HIV are an essential part of the continuum of HIV care. J Int AIDS Soc. 2018;21(10):e25188.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Jeste DV, Palmer BW, Rettew DC, Boardman S. Positive psychiatry: its time has come. J Clin Psychiatry. 2015;76(6):675–83.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Illa L, Echenique M, Bustamante-Avellaneda V, Sanchez-Martinez M. Review of recent behavioral interventions targeting older adults living with HIV/AIDS. Curr HIV/AIDS Rep. 2014;11(4):413–22.

    Article  PubMed  Google Scholar 

  69. Fazeli PL, Hopkins CN, Wells A, Lambert CC, Turan B, Kempf MC, et al. Examining the acceptability of a resilience building intervention among adults aging with HIV. J Assoc Nurses AIDS Care. 2021. https://doi.org/10.1097/jnc.0000000000000229.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Mohammadi N, Aghayousefi A, Nikrahan GR, Adams CN, Alipour A, Sadeghi M, et al. A randomized trial of an optimism training intervention in patients with heart disease. Gen Hosp Psychiatry. 2018;51:46–53.

    Article  PubMed  Google Scholar 

  71. Heckman TG, Heckman BD, Anderson T, Lovejoy TI, Mohr D, Sutton M, et al. Supportive-expressive and coping group teletherapies for HIV-infected older adults: a randomized clinical trial. AIDS Behav. 2013;17(9):3034–44.

    Article  PubMed  Google Scholar 

  72. Shamsaei F, Tahour N, Sadeghian E. Effect of stress management training on stigma and social phobia in HIV-positive women. J Int Assoc Provid AIDS Care. 2020;19:2325958220918953.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Hunter-Jones J, Gilliam S, Davis C, Brown D, Green D, Hunter C, et al. Process and outcome evaluation of a mindfulness-based cognitive therapy intervention for cisgender and transgender African American women living with HIV/AIDS. AIDS Behav. 2021;25(2):592–603.

    Article  CAS  PubMed  Google Scholar 

  74. Gray J, Cason CL. Mastery over stress among women with HIV/AIDS. J Assoc Nurses AIDS Care. 2002;13(4):43–57.

    Article  PubMed  Google Scholar 

  75. Carver CS. You want to measure coping but your protocol’s too long: consider the Brief COPE. Int J Behav Med. 1997;4:92–100.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS), now the MACS/WIHS Combined Cohort Study (MWCCS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). MWCCS (Principal Investigators): Atlanta CRS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-HL146241; Bronx CRS (Kathryn Anastos and Anjali Sharma), U01-HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202; Data Analysis and Coordination Center (Gypsyamber D’Souza, Stephen Gange and Elizabeth Golub), U01-HL146193; UNC CRS (Adaora Adimora), U01-HL146194. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Institute On Aging (NIA), National Institute Of Dental & Craniofacial Research (NIDCR), National Institute Of Allergy And Infectious Diseases (NIAID), National Institute Of Neurological Disorders And Stroke (NINDS), National Institute Of Mental Health (NIMH), National Institute On Drug Abuse (NIDA), National Institute Of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute on Minority Health and Health Disparities (NIMHD), and in coordination and alignment with the research priorities of the National Institutes of Health, Office of AIDS Research (OAR). MWCCS data collection is also supported by UL1-TR000004 (UCSF CTSA), UL1-TR003098 (JHU ICTR), UL1-TR001881 (UCLA CTSI), P30-AI-050409 (Atlanta CFAR), P30-AI-073961 (Miami CFAR), P30-AI-050410 (UNC CFAR), P30-AI-027767 (UAB CFAR), and P30-MH-116867 (Miami CHARM).

Funding

This work was assisted in part by a developmental grant (Anna Rubtsova, PI) from the NIH Center for AIDS Research at Emory University (P30AI050409), Sustained Training in HIV and Aging (STAHR) training grant (R25 MH108389—Scott Letendre and Dilip Jeste, PIs), Atlanta CRS (U01-HL146241—Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood, PIs), and Emory SCORE (U54AG062334—Igho Ofotokun, PI).

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Authors and Affiliations

  1. Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA, 30322, USA

    Anna A. Rubtsova

  2. Department of Sociomedical Sciences, Mailman School of Public Health at Columbia University, New York, NY, USA

    Gina Wingood

  3. Department of Medicine, Division of Infectious Diseases at Emory University, Atlanta, GA, USA

    Ighovwerha Ofotokun

  4. Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA, USA

    C. Christina Mehta

  5. Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA

    Deborah Gustafson

  6. The University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA

    David E. Vance

  7. Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA

    Anjali Sharma

  8. Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Adaora A. Adimora

  9. Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA

    Marcia Holstad

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  1. Anna A. Rubtsova
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Contributions

Conceptualization: AAR, GW, MH, DEV; Methodology and Data Collection: AAR, GW, IO, CCM, DG, DEV, AS, AAA, MH; Data Analysis: AAR and CCM. The first draft was written by AAR and all authors provided reviews, comments, and editing.

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Correspondence to Anna A. Rubtsova.

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Data in this manuscript were collected by the Women’s Interagency HIV Study (WIHS). WIHS research protocols were approved by Institutional Review Boards at each study site.

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N/A. The manuscript does not contain identifying information about participants.

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Annual Scientific Meeting of the Gerontological Society of America, November 6, 2020. Virtual.

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Rubtsova, A.A., Wingood, G., Ofotokun, I. et al. Psychosocial Mechanisms of Self-rated Successful Aging with HIV: A Structural Equation Model. AIDS Behav 25, 2875–2885 (2021). https://doi.org/10.1007/s10461-021-03340-7

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