Strategies adopted by late middle-age and older adults with HIV/AIDS to explain their physical symptoms

Siegel, Karolynn; Lekas, Helen‐Maria; Schrimshaw, Eric W.; Brown-Bradley, Courtney J.

doi:10.1080/08870441003681299

Cited by 8 publications

(4 citation statements)

References 96 publications

(56 reference statements)

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“…However, we found a lower prevalence of distressing symptoms in the over 40 s group compared with younger age groups, which is accordance in a previous study [29]. This could, in part, be attributable to older adults attributing health changes to natural ageing and therefore not rating them as distressing [52,53].…”

Section: Discussionsupporting

confidence: 91%

Association between HIV duration and symptom distress among middle-aged and elderly people with HIV-infected in China: a cross-sectional study

Xie

Wang

et al. 2022

BMC Geriatr

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Background Debate has persisted regarding whether PLWH with longer HIV durations have lower levels of prevalence and severity of symptoms compared with their newly diagnosed counterparts. Whether and how the HIV duration impact the symptom distress among middle-aged and older PLWH has not been explored clearly. Methods The patients with HIV-infected aged more than 40 years old were included from seven designated medical institutions of seven regions in China. Outcome was the score of symptom distress. We used the multiple regression model to calculate adjusted Coefficient of Regression (β) with 95% CI in this study. Results Among 210 participants (mean age 50.8 years; 71.0% male; 68.1% at asymptomatic stage) in the study, the median number of symptoms was 5. Of all symptoms reported, the most distressed symptoms were sleep disturbance (33.33%), followed by memory loss (31.90%), fatigue (26.67%), slow reactions (22.86%), and vision blur (21.90%). All participants were divided into four groups according to HIV duration, and the median of total score of symptom ditress among all participants was 0.1(0.0,0.9). Difference of total scores and clusters’ scores of symptom distress among four HIV duration groups were statistically significant. 51 participants with 6–10 years HIV duration were more likely to be higher level of education, at asymptomatic stage and have higher CD4 + T cell count. After adjustment for gender, age, race, education, marital status, employment, family income, region, stage of disease and CD4 + T cell count, the score of symptom distress among participants with 6–10 years HIV duration had was higher with the extension of HIV duration. Specially in physical symptoms and psychological symptoms,participants with 6–10 years HIV duration reported the persisting worse burdensome. Conclusions HIV duration with 6–10 yearsmay be a key period that the medical team needs to pay special attention to among middle-aged and elderly PLWH. There is a need to provide medical and psychosocial services targeting middle-aged and elderly PLWH according to their changing symptom distress. Trial registration Clinicaltrials.gov: ChiCTR2100046225. Registered 11 May 2021.

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Section: Discussionsupporting

confidence: 91%

Association between HIV duration and symptom distress among middle-aged and elderly people with HIV-infected in China: a cross-sectional study

Xie

Wang

et al. 2022

BMC Geriatr

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“…However, we found a lower prevalence of distressing symptoms in the over‐60s group compared with younger age groups, both overall and for many symptom subgroups. This could, in part, be attributable to older adults attributing health changes to natural ageing and therefore not rating them as distressing . Previous research also posits that older adults may face fewer high‐demand situations as a consequence of retirement, leaving increased time and mental reserves for coping with physical distress .…”

Section: Discussionmentioning

confidence: 99%

Age, time living with diagnosed HIV infection, and self‐rated health

et al. 2016

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ObjectivesAn increasing proportion of people living with HIV are older adults, who may require specialized care. Adverse physical and psychological effects of HIV infection may be greatest among older people or those who have lived longer with HIV.MethodsThe ASTRA study is a cross‐sectional questionnaire study of 3258 HIV‐diagnosed adults (2248 men who have sex with men, 373 heterosexual men and 637 women) recruited from UK clinics in 2011–2012. Associations of age group with physical symptom distress (significant distress for at least one of 26 symptoms), depression and anxiety symptoms (scores ≥ 10 on PHQ‐9 and GAD‐7, respectively), and health‐related functional problems (problems on at least one of three domains of the Euroqol 5D‐3L)) were assessed, adjusting for time with diagnosed HIV infection, gender/sexual orientation and ethnicity.ResultsThe age distribution of participants was: < 30 years, 5%; 30–39 years, 23%; 40–49 years, 43%; 50–59 years, 22%; and ≥ 60 years, 7%. Overall prevalences were: physical symptom distress, 56%; depression symptoms, 27%; anxiety symptoms, 22%; functional problems, 38%. No trend was found in the prevalence of physical symptom distress with age [adjusted odds ratio (OR) for trend across age groups, 0.96; 95% confidence interval (CI) 0.89, 1.04; P = 0.36]. The prevalence of depression and anxiety symptoms decreased with age [adjusted OR 0.86 (95% CI 0.79, 0.94; P = 0.001) and adjusted OR 0.85 (95% CI 0.77, 0.94; P = 0.001), respectively], while that of functional problems increased (adjusted OR 1.28; 95% CI 1.17, 1.39; P < 0.001). In contrast, a longer time with diagnosed HIV infection was strongly and independently associated with a higher prevalence of symptom distress, depression symptoms, anxiety symptoms, and functional problems (P < 0.001 for trends, adjusted analysis).ConclusionsAmong people living with HIV, although health‐related functional problems were more common with older age, physical symptom distress was not, and mental health was more favourable. These results suggest that a longer time with diagnosed HIV infection, rather than age, is the dominating factor contributing to psychological morbidity and lower quality of life.

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“…Of these, five studies conducted in five different MS, analysed correlates of late presentation at diagnosis among HIV patients [19][20][21][22]. Invariably the findings indicated older age to be an independent risk factor for late diagnosis.…”

Section: Patterns Of New Hiv Diagnosis and Hiv Test Uptakementioning

confidence: 99%

“…Patient Limited health literacy and knowledge about HIV [13,16,17] Misconceptions about and low self-perception of the risk to acquire HIV [13,[18][19][20] Lack of discussion about sexuality and sexual health with health care provider [21][22][23] Alternative explanations to account for disease's symptoms [24] Being at higher risk of transmission (i.e., MSM, IDU) [19,25,26] High frequency of health care services contact [13,18,23,26] Provider-initiated testing [18,19] Provider-initiated partner notification services [27] Higher level of education [25] Engage in discussion about sexual health with health care provider [28] Physical symptoms [19] Provider Missed opportunities to offer HIV to patients, including those presenting with indicator-conditions or risk-factors [17,[29][30][31][32][33][34][35][36] No routine collection of sexual history and risk assessment [13,17,[36][37][38] Lack of specific professional education [13,17,39] Lack of specific guidelines and information material [13,…”

Section: Barriers Enablersmentioning

confidence: 99%

New HIV Diagnoses among Older Adults in the EU/EEA: Missed Opportunities and Barriers to Testing

Tavoschi¹,

Madeddu²,

Pharris³

2017

J AIDS Clin Res

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The rate of HIV diagnoses among older adults in the European Union/European Economic Area (EU/EEA) is increasing. We performed a literature review to investigate factors associated with HIV infection, diagnosis and testseeking behaviour among older adults in the EU/EEA.We defined older adults as ≥ 50 years. We searched Embase and PubMed to identify studies on socio-demographic and clinical characteristics associated with new HIV diagnosis and factors influencing provision and uptake of HIV testing among older adults in EU/EEA and other high-income countries using the concepts of HIV infection and disease; older adults, and; testing and attitude towards testing. We included original papers or systematic reviews published from 2000 onwards and reporting data on the following themes: Patterns of HIV test uptake and attitudes, barriers and enablers influencing offer and uptake of HIV testing.Published evidence indicated large proportion of late diagnoses and a low likelihood of HIV testing among older adults, although results varied widely between studies. HIV test uptake was a function of several factors related to patient and provider, including perception of one's risk. The active offer of an HIV test by the health care provider was the most significant factor positively associated with having a test. Scaling up HIV testing opportunities targeting older adults and the adult population at large is needed.

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Strategies adopted by late middle-age and older adults with HIV/AIDS to explain their physical symptoms

Cited by 8 publications

References 96 publications

Association between HIV duration and symptom distress among middle-aged and elderly people with HIV-infected in China: a cross-sectional study

Association between HIV duration and symptom distress among middle-aged and elderly people with HIV-infected in China: a cross-sectional study

Age, time living with diagnosed HIV infection, and self‐rated health

New HIV Diagnoses among Older Adults in the EU/EEA: Missed Opportunities and Barriers to Testing

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