All ETDs from UAB

Advisory Committee Chair

David E Vance

Advisory Committee Members

Crystal Chapman Lambert

D Scott Batey

Anand Iyer

Pariya Fazeli Wheeler

Document Type

Dissertation

Date of Award

2023

Degree Name by School

Doctor of Philosophy (PhD) School of Nursing

Abstract

Older adults with human immunodeficiency virus (HIV) experience a high prevalence of chronic obstructive pulmonary disease (COPD). Considering having either HIV or COPD is related to worse health outcomes in older adults, aging with both HIV and COPD may synergistically and negatively affect the health outcomes of older people with HIV (PWH) and comorbid COPD. The purpose of this dissertation was to explore the aging of PWH with COPD. This purpose was accomplished through three articles: 1) an adaptation of a gerontological model investigating what is known about the aging of PWH and people with COPD and extrapolating that to PWH with COPD, 2) a qualitative study of three cases exploring experiences related to intersectional stigma in older PWH with COPD, and 3) a cross-sectional descriptive study examining differences in psychological symptomatology and quality of life between older PWH with and without COPD using secondary data from the University of Alabama at Birmingham (UAB) 1917 Clinic Cohort. Article 1 provided a conceptual framework that can be utilized for research and clinical practice for those who age with HIV and comorbid COPD. Article 2 showed that stigmas of HIV and COPD exist when approached separately, but the stigma of HIV overshadows that of COPD when approached together. Article 3 found depressive symptoms and quality of life are worse in older PWH with COPD than those without COPD. The findings from the dissertation underscore the need for further research on aging with HIV and COPD based on the proposed framework. Furthermore, it is iv important for healthcare providers to consider the high prevalence of COPD and its potential impact on aging when assessing the health outcomes of older PWH.

Available for download on Monday, August 10, 2026

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