HIV/AIDS and the Older Adult: An Exploratory Study of the Age-Related Differences in Access to Medical and Social Services

Abstract

This was an exploratory study investigating age-related differences in access to medical and social services among individuals infected with HIV/AIDS. Its primary purpose was to investigate the experiences that older adults with HIV/AIDS have had with accessing HIV/AIDS-related medical and social services and to compare their experiences to those of infected younger adults. The study also investigated the perceptions that younger and older adults have about the need to, or value of, providing specific medical and social services for older infected adults in order to understand current and future service needs and potential service accessibility issues.Data were collected from 34 in-depth interviews and findings allowed for both quantitative and qualitative analysis. The Student's t-test was employed to evaluate age group differences in access and descriptive analyses were used to supplement and elaborate on the statistical analyses. The older adult's ability to access services was evaluated by addressing predisposing, enabling and need variables in addition to characteristics associated with the medical and social service systems. The Student's t-test revealed that older adults accessed fewer medical services, health information sources and social organizations compared to younger aged adults. However, they accessed a similar number of social and emotional supports compared to younger aged adults, and reported fewer barriers to accessing services compared to younger adults. Descriptive analyses revealed that infected older adults had positive experiences accessing both health care professionals and organizations, and that they accessed a variety of HIV/AIDS-specific and non-specific social organizations. HIV/AIDS-related stereotypes held by the gay community limited the older adults' access to services to some degree. Younger adults however, experienced similar stereotypes.Through qualitative analysis, three major themes explained the findings of this study: the older adults maintained an independent and forthright attitude about service access, had a comprehensive knowledge of their infection and available services and they resided in a service rich geographic area.

Emotional social support and access to care among older people living with HIV in rural China

“…Existing literature has documented that elderly patients are more likely to experience delayed access to health care (Lanoy et al, 2007; Mojumdar et al, 2010). This delay in health care may be due to age-related declines in physical and cognitive functioning that hinder the elderly from seeking health care and health-related information (Cahill and Valadez, 2013; Fritsch, 2005). In addition to the prevailing discrimination and rejection towards PLH, elderly PLH are facing amplified stigma correlated with comorbidity, disability, and cognitive and functional decline (Dobbs et al, 2008; Emlet, 2006).…”

“I'm still raring to go”: Successful aging among lesbian, gay, bisexual, and transgender older adults

“…For example, HIV+ older adults express strengths related to living with HIV/AIDS in areas including self-acceptance, optimism, will to live, self-management, relational living, and independence (Charles A. Emlet, Tozay, & Raveis, 2011). Many HIV+ older adults have resources that enable access to medical and social services sufficient for coping, including positive attitude, HIV/AIDS knowledge and available social support -- especially from gay communities (Fritsch, 2005). HIV+ older adults make use of social support networks of other HIV+ people that buffer against stigma (Poindexter & Shippy, 2008) and improve mental health and well-being (Chesney, Chambers, Taylor, & Johnson, 2003).…”

HIV and ageing: what the geriatrician needs to know

“…125 Despite this apparent vulnerability, a small qualitative study found that older adults were knowledgeable about HIV and its treatment, were conscious of personal health and social needs and knew where they could access resources. 126 In addition to fragile social networks, when assessed by age, older HIV+ individuals have been shown to experience higher levels of poverty compared with those under 50. 127 Those exposed to HIV for longer durations (particularly pre-ART acquisition) may be at greatest risk of financial disadvantage due to interruptions in careers or earning potential due to HIV-related illness, resulting in dependence on social security.…”

“…132 Older adults themselves are keen that issues of ageing are integrated into HIV services, particularly in proactive rather than reactive ways. 126 In the UK, various models of care are emerging. Waters et al published their experiences of running a dedicated 50-plus multi-disciplinary clinic since 2009.…”