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

Anna A. Rubtsova, Gina Wingood, Ighovwerha Ofotokun, C. Christina Mehta, Deborah Gustafson, David E. Vance, Anjali Sharma, Adaora A. Adimora, Marcia Holstad

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)2875-2885
Number of pages11
JournalAIDS and Behavior
Issue number9
StatePublished - Sep 2021


  • Aging well
  • Healthy aging
  • Older adults
  • Positive psychosocial factors
  • Structural equation modeling

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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