“HIV Is Not Going to Kill Me, Old Age Is!”: The Intersection of Aging and HIV for Older HIV-Infected Adults in Rural Communities

Abstract

Older adults with HIV/AIDS living in rural areas face unique challenges to accessing HIV care and medications, and suffer greater mortality than non-rural HIV-infected individuals. This qualitative study examined the intersection of aging and HIV to identify factors that affect overall health, engagement in care, and medication adherence among this understudied population. Qualitative interviews were conducted by phone with 29 HIV-positive adults over the age of 50 living in US rural counties and analyzed using thematic content analysis. Individuals reported complex medical needs in addition to their HIV and noted difficulty discerning whether symptoms were associated with HIV or aging. Although reported medication adherence rates were high, participants also cited several barriers to maintaining adherence. Given the increase in rural individuals living with HIV coupled with an aging population of HIV-infected individuals, interventions are needed to address the complex intersection of aging and HIV, especially for those in rural environments.

Navigating Life with HIV as an Older Adult in South African Communities: A Phenomenological Study

“…The current study revealed that some participants had mixed feelings in deciding whether to disclose or not. Consistent with previous studies, they used nondisclosure as a stigma management tool [11,38]. They lived in multigenerational households, and when they learned about their HIV-positive status, they found it difficult to disclose it to some of the members of the household.…”

Challenges with seeking HIV care services: perspectives of older adults infected with HIV in western Kenya

“…Participants in our study identified social support for persons living with HIV as an important factor in developing a supportive connection and improving HIV treatment adherence. Previous studies, including work done by researchers in Uganda Virus Research Institute, have also shown that social support improves HIV coping strategies [34,47,48], promote self-management of chronic diseases [10] and reduce experiences with stigma and discrimination [40,47]. Unlike younger adults who have a circle of friends and would likely receive social support from their network [49], older adults are more likely have either lost ties with their friends or are widowed and are not quick to form new relationships [21].…”

“…If ART is initiated in the presence of co-morbidities, care providers have to closely monitor ART regimens for early switching in cases of ART toxicities [8,9]. Furthermore, HIV patients with comorbid conditions, require multiple prescriptions, which not only make it difficult to track the medication but also threaten patients' ability to adhere to ART [10]. Previous research has shown that older adults who are nonadherent to ART are more likely to present with depressive symptoms associated with stigma and loneliness [11].…”

Older African Americans and the HIV Care Continuum: A Systematic Review of the Literature, 2003–2018

“…The studies included highlight several major barriers and facilitators at each step of the HIV care continuum that should be considered in implementing tailored policies and culturally relevant programs that seek to improve engagement in the HIV care continuum for an aging population of African Americans who continue to be disproportionately impacted. These include a targeted focus on older adults within HIV education and prevention programs [33]; providing social, financial, and medical support to those who suffer from multimorbidities [49]; and expanding HIV-clinic based care to improve treatment and adherence outcomes among older African Americans [39].…”