MSc Research Summary

My MSc thesis at City St Georges, University of London set out to explore a question that is both academically important and deeply human: What are the experiences of older adults living with HIV when it comes to adhering to their medication, and how does this affect their daily lives?

We know that HIV is no longer the “death sentence” it was once perceived to be. Thanks to antiretroviral therapy (ART), people living with HIV are now living longer, healthier lives. But this progress brings a new challenge: an ageing HIV-positive population, with over half of people living with HIV in many countries now over the age of 50. This demographic shift means we must ask not just how HIV is managed medically, but how people experience living - and ageing - with it day to day.

To investigate this, I conducted a systematic review of ten qualitative studies, analysing first-hand accounts of older people (50+) living with HIV. These studies provided rich, personal insights into what it means to keep taking medication every single day, often for decades, while navigating the realities of ageing, stigma, and health systems.

From this work, seven themes emerged:

• Emotional and psychological experiences - medication adherence is not just about routine,
  but about coping with stigma, anxiety, and the mental toll of a lifelong condition.

• Social relationships and dynamics - family, friends, peer groups, and healthcare providers
  play a vital role in encouraging or sometimes complicating adherence.

• Cognitive development and self-discovery - ageing with HIV often forces individuals to renegotiate identity, resilience, and self-understanding.

• Health and wellbeing - adherence links directly to quality of life, but ageing adds layers of complexity through comorbidities and polypharmacy.

• Struggles and challenges - practical issues like finances, side effects, or transportation
  barriers can disrupt even the strongest intentions to adhere.

• Ethics and truth - many face difficult choices around disclosure and honesty, balancing
  dignity with fear of stigma.

• Existential and societal reflections - people reflect not only on their own survival but also
  on the collective history of HIV, loss, and resilience.

Perhaps the most striking finding was the recurring theme of the “will to live.” For many older adults, adherence was not framed as a burden, but as an act of survival, self-determination, and even defiance. Taking medication was seen as choosing life - a conscious statement of resilience in the face of both illness and stigma.

What this research highlights is simple but powerful: adherence is never just clinical. It is emotional, social, and existential. To support older adults living with HIV, healthcare must go beyond prescribing medication. It must acknowledge the lived realities of ageing, the importance of social support, and the enduring presence of stigma.

For practitioners, this means approaching care holistically: listening to people’s stories, recognising resilience as much as vulnerability, and tailoring support that acknowledges the individual behind the diagnosis. For policymakers, it reinforces the need for inclusive, age-sensitive, and stigma-free healthcare frameworks.

Ultimately, this research calls us to see older people living with HIV not only as patients but as long-term survivors whose voices can shape better futures - for themselves and for the next generations living with HIV.

Why This Research Matters to Me
This research was important to me because HIV is more than a medical diagnosis - it is a lifelong experience that shapes identity, relationships, and resilience. For decades, the story of HIV has often been told through the lens of crisis, stigma, and statistics. Yet the reality is that people are living longer with HIV, and older adults now make up a significant proportion of those affected. Their voices are rarely centred in research or policy, despite the fact that they navigate some of the most complex intersections of health, ageing, and stigma.

Coming from both clinical practice and a background in psychology, I wanted to bring a holistic perspective to this issue - one that recognises adherence not only as a biomedical process but as something deeply emotional, social, and existential. My aim was to illuminate the day-to-day realities of older adults living with HIV: the challenges of managing multiple medications, the impact of stigma on self-worth, but also the extraordinary resilience and determination - the “will to live” - that drives adherence and survival.

This work matters because it bridges the gap between numbers and narratives, between the statistics that dominate public health reports and the lived realities of those who carry HIV into older age. Data can tell us how many people are virally suppressed, or how adherence rates compare across demographics, but numbers alone cannot capture the daily negotiations, the silent resilience, or the quiet determination that underpin those outcomes.

If we truly want to improve health outcomes, we must go beyond measuring adherence to understanding it - listening to the voices of people who have navigated decades of treatment, stigma, and survival. Their insights do more than describe challenges; they offer a roadmap for what care, policy, and support should look like when it is rooted in human experience.

For me, this project was never just an academic exercise. It was a commitment: to amplify voices that too often go unheard, to surface the complexity of ageing with HIV, and to advocate for care that does not reduce people to their viral load or medication regime. My goal is to help shape healthcare and policy that recognises people not simply as patients, but as whole individuals - ageing with dignity, meaning, and strength, and deserving of systems that honour both their survival and their humanity.