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Significantly elevated rates of PTSD are observed with high frequency in PLWHA. Several coping behaviors have been identified that can ameliorate PTSD symptoms and associated spectrums of depression. In a study of almost 250 African American women (54% were age 45 and older) multiple factors were assessed for their protective association as evidenced by reduced PTSD symptoms. The variables studied were age, marital status, education, internalized HIV-related stigma, and social support. Older age showed a significant but small association with reduced PTSD symptoms. Many have postulated that with age there is increased resiliency. More significant protective factors were education, marital status, and social supports. But internalized sigma was the most significant contributor to increased PTSD symptoms. The data supports the need for better trauma informed strategies to address PTSD. Stigma remains pervasive and results in reduced health outcomes.