“Living Through Two Storms”: A Narrative Enquiry of Older Adults’ Experiences with HIV/AIDS During the COVID-19 Pandemic in Nigeria

Abstract

The COVID-19 pandemic has illuminated and intensified pre-existing structural vulnerabilities among older adults living with HIV/AIDS in sub-Saharan Africa, particularly Nigeria. Within already overstretched healthcare infrastructures, these individuals faced heightened economic precarity, disrupted HIV care, and pronounced psychosocial distress. Exploring their lived experiences critically advances an understanding of resilience and informs contextually responsive interventions that can mitigate future health crises. This study employed a narrative qualitative approach to explore the lived experiences of older adults (aged 50 and above) attending the Infectious Diseases Institute (IDI) clinic in Ibadan, Nigeria, during the pandemic lockdown. Purposive sampling guided by maximum variation principles enabled the selection of 26 participants who provided detailed accounts through in-depth interviews. Reflective thematic analysis identified complex narratives illustrating intensified financial hardships, disrupted access to antiretroviral therapy (ART), and heightened psychological distress, including anxiety, depression, and profound isolation. Conversely, participants also articulated experiences of resilience, manifesting in improved medication adherence, strengthened family bonds, and introspective growth fostered by enforced isolation. These nuanced findings highlights the necessity of developing an adaptive, integrated healthcare interventions that addresses economic vulnerabilities, psychosocial wellbeing, and ART continuity, thereby better preparing resource-constrained health systems to support older adults with HIV/AIDS in future public health crises.