Charles A. Emlet

Background and Objectives: Generativity, a concern and commitment for others, has shown to be positively associated with health and well-being. Research on generativity in sexual and gender minority (SGM) communities is limited, despite its potential importance given the marginalization older SGM individuals face and limited interaction between generations. We integrate Generativity Theory and the Health Equity Promotional Model to examine key factors for generativity and subgroup differences among SGM midlife and older adults. Research Design and Methods: Using 2016 data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (N = 2,233), we regressed generativity on social location and adverse experiences and subsequently on psychological and social factors. We also tested the moderating effects of social location and psychological and social factors. Results: Psychological (mastery, resilience, and critical awareness) and social (social participation, network size, social support, and SGM community engagement) factors were positively associated with generativity. Day-to-day discrimination was negatively, and lifetime violence and microaggressions were positively associated with generativity. With higher critical awareness level, day-to-day discrimination no longer had negative effects. With higher mastery level, lifetime discrimination had positive effects. Resilience and network size were stronger predictors for younger generations. Discussion and Implications: Findings highlight that psychological and social resources may foster posttraumatic growth and generativity. Critical awareness, activism, and social connections appear important to stand strong against prevalent oppression and extends generative support to younger SGM generations. This research provides insight to promote intergenerational relationships and to cultivate agentic and communal strengths in the SGM populations.

Objectives Utilizing Iridescent Life Course, we examine life events among three generations of lesbian and gay adults: Invisible (born 1920–1934), Silenced (born 1935–1949), and Pride (born 1950–1964) Generations. Methods: We utilized a subsample ( n = 2079) from the 2014 wave of Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS). Demographic characteristics, life events, and gender and generational interactions were compared. Results: Compared to other generations, the Invisible Generation disclosed their identity at older ages, were more likely to be retired, served in the military, and survived a partner’s death. Compared to the other generations, the Pride Generation was more likely to have disclosed their identities earlier and experienced higher levels of victimization/discrimination. Discussion: This paper is the first to examine the lived experiences of the oldest lesbians and gay men and compare them to other generations. The findings illustrate the heteronormative nature of most life course research.

Background and Objectives: Prior research has shown informal caregiving among older adults can negatively affect the caregiver’s physical and psychological health. However, little is known about protective and risk factors associated with the health-related quality of life (HRQOL) of lesbian, gay, bisexual, transgender, and queer (LGBTQ) caregivers. Research Design and Methods: Informed by the Health Equity Promotion Model and Caregiver Stress Process Model and utilizing longitudinal data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study, this analysis examined modifiable risk and protective factors associated with psychological and physical HRQOL over time among 754 LGBTQ caregivers aged 50–98. Results: Psychological and physical HRQOL declined over a 3-year period. After controlling for background characteristics, mastery, social support, socialization, LGBTQ community engagement, and physical activity were positively associated with psychological HRQOL while day-to-day discrimination, identity stigma, and insufficient food intake were negatively associated. Steeper declines were observed for older and with no physical activity. Mastery, social support, socialization, and physical activity were positively associated with physical HRQOL while day-to-day discrimination and insufficient food intake were negatively associated. Steeper declines were found for those with high mastery and no physical activity. Discussion and Implications: Although generalized factors including mastery, socialization, and social support are protective for HRQOL among LGBTQ caregivers, factors including day-to-day discrimination and identity stigma are more unique to historically disadvantaged populations and should be considered in future research and practice. Caregiving interventions incorporating physical activity are promising given its buffering effect for decreased physical and psychological HRQOL over time.

Background: Caregivers experience chronic stress that can negatively affect their health, resulting in lower quality of life. This study aims to understand the physical and mental health of caregivers by examining modifiable risk and protective factors. Life experiences of LGBT older adults are considered.Method: In the longitudinal study, Aging with Pride: National Health Aging, Sexuality/Gender Study, approximately one third (31%, n=754) of LGBT older adults (50+ years) provide care: 38% to partner/spouse, 29% friends, 20% other relatives, and 8% ex‐partner/ex‐spouse. Linear regression models examined the effects of risk and protective factors at T₀ on health outcomes at T₂.Result: Mastery, physical activity, and nutrition predicted better physical functioning, lower mental distress, and higher health‐related quality of life (HRQOL). Social participation and support, community engagement, and lower identity stigma predicted better mental health. Microaggressions predicted lower physical HRQOL.Conclusion: Interventions enhancing protective factors may promote physical and mental health of LGBT caregivers.

Objectives: This is the first national population-based study to examine cognitive impairment disparities among sexual minority mid-life and older adults. Methods: Using the National Health Interview Survey (2013–2018), we compared weighted prevalence of subjective cognitive impairment by sexual orientation and gender, among those aged 45 plus, applying logistic regressions adjusting for age, income, education, race/ethnicity, and survey years. Results: Sexual minorities (24.5%) were more likely to have subjective cognitive impairment than heterosexuals (19.1%). Sexual minority women had higher odds of greater severity, frequency, and extent of subjective cognitive impairment. Sexual minorities were also more likely to report activity limitations resulting from cognitive impairment and were no more likely to attribute limitations to dementia or senility. Discussion: Cognitive health disparities are of particular concern in this historically and socially marginalized population. The investigation of explanatory factors is needed, and targeted interventions and policies are warranted to address cognitive challenges faced by sexual minorities.

Objective: This study examines whether disparities exist in poor health and depressive symptomatology among older gay/bisexual men (50+) with (n = 371) and without (n = 973) HIV. If so, what risk/promoting factors account for those disparities? Method: These cross-sectional analyses used 2014 data from the Aging With Pride: National Health, Aging, and Sexuality/Gender Study. Results: Those with HIV reported poorer health and more depressive symptomatology accounted for by lower income, resilience and social support, and more lifetime victimization. Poorer health among those with HIV was associated with more chronic conditions. Higher depressive symptomatology was associated with diagnosed anxiety and drug addiction. Community engagement reduced disparities in poor health and depression. Implications: Older gay/bisexual men living with HIV infection are at greater risk for physical and mental health issues. Assessments should be conducted with attention to these risk factors. Interventions for improving social support, resilience, and community engagement are warranted.

According to Joint United Nations Programme on HIV/AIDS (UNAIDS) data, 36.9 million people are living with HIV worldwide. Older adults, those aged 50 years and older, with HIV are increasing worldwide; however, the prevalence and incidence differ substantially across regions. The purpose of this article is to provide an overview of how HIV is impacting older adults globally, with a focus on sexual and gender minority older adults. The article is organized using the eight geographical regions from UNAIDS, with information on the prevalence and incidence among older adults. Among sexual and gender minority older adults, key risks are identified, including laws that criminalize same-sex relationships; issues of stigma and fear; and the concomitant lack of access and barriers to HIV testing, treatment, and prevention. Progress within each region toward the UNAIDS 90-90-90 targets is included, and suggestions for future directions of research and service delivery are made.

Objectives: Successful aging has been identified as an important emphasis for people living with human immunodeficiency virus (HIV). Little is known about how this population conceptualizes aging successfully and how this relates to generativity. This qualitative study examined the importance of generativity among 30 HIV-positive older adults to determine the role of generativity in successful aging. Method: Participants aged 50+ years were recruited in Ontario, Canada, through acquired immunodeficiency syndrome (AIDS) service organizations, clinics, and community agencies. Qualitative interviews were analyzed to explore strategies participants employed to engage in successful aging within their own personal context. Results: Participants saw themselves as pioneers and mentors, helping others to navigate the landscape of aging with HIV. Four themes were identified through consensus including (a) reciprocity, (b) mentoring, (c) pioneerism, and (d) connecting through volunteerism. Discussion: Interventions that promote intergenerational connections, community involvement, and generative acts within the HIV community can facilitate successful aging among older adults living with HIV/AIDS.