HIV/AIDS in Later Life

Oxford Research Encyclopedia of Psychology ◽

10.1093/acrefore/9780190236557.013.430 ◽

2018 ◽

Author(s):

Philip Sayegh ◽

David J. Moore ◽

Pariya Fazeli Wheeler

Keyword(s):

Successful Aging ◽

Neuropsychiatric Symptoms ◽

Later Life ◽

Well Being ◽

The United States ◽

Neurocognitive Deficits ◽

Everyday Functioning ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

Since the first cluster of people with HIV was identified in 1981, significant biomedical advances, most notably the development of antiretroviral therapy (ART), have led to considerably increased life expectancy as well as a reduction in the morbidity and mortality associated with HIV/AIDS. As a result, HIV/AIDS is no longer considered a terminal illness, but rather a chronic illness, and many persons living with HIV/AIDS are beginning to enter or have already reached later life. In fact, Americans ages 50 years and older comprise approximately half of all individuals with HIV/AIDS and represent the most rapidly growing subpopulation of persons living with HIV/AIDS in the United States. Despite significant advances in HIV/AIDS treatment and prognosis, older adults living with HIV (OALH) face a number of unique challenges and circumstances that can lead to exacerbated symptoms and poorer outcomes, despite demonstrating generally better ART adherence than their younger counterparts. These detrimental outcomes are due to both chronological aging and cohort effects as well as social and behavioral factors and long-term ART use. For instance, neurocognitive deficits and neuropsychiatric symptoms, including depression, anxiety, apathy, and fatigue, are often observed among OALH, which can result in feelings of loneliness, social isolation, and reduced social support. Taken together, these factors can lead to elevated levels of problems with everyday functioning (e.g., activities of daily living) among OALH. In addition, sociocultural factors such as race/ethnicity, ageism, sexism, homophobia, transphobia, geographic region, socioeconomic status and financial well-being, systemic barriers and disparities, and cultural values and beliefs play an influential role in determining outcomes. Notwithstanding the challenges associated with living with HIV/AIDS in later life, many persons living with HIV/AIDS are aging successfully. HIV/AIDS survivor and community mobilization efforts, as well as integrated care models, have resulted in some significant improvements in overall HIV/AIDS patient care. In addition, interventions aimed at improving successful aging outcomes among OALH are being developed in an attempt to effectively reduce the psychological and physical morbidity associated with HIV disease.

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Counselling for Psychological Well-Being in Persons Living with HIV/AIDS

Journal of Psychology in Africa ◽

10.1080/14330237.2009.10820329 ◽

2009 ◽

Vol 19 (4) ◽

pp. 561-563 ◽

Cited By ~ 1

Author(s):

Stephen D. Edwards ◽

David J. Edwards

Keyword(s):

Well Being ◽

Psychological Well Being ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

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Sociocultural Factors Influencing The Transmission of HIV/AIDS in The United States

10.1093/med/9780199392742.003.0009 ◽

2017 ◽

Author(s):

Robert E Fullilove

Keyword(s):

United States ◽

Criminal Justice ◽

Correctional Facility ◽

The United States ◽

Hiv Care ◽

Sociocultural Factors ◽

Effective Interventions ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

This chapter discusses the unique impact that social disadvantage in general and the criminal justice systems in the United States in particular have on the conditions that drive the HIV/AIDS epidemic in this country. HIV/AIDS is classified as an important racial/ethnic health disparity because residents of marginalized black and Hispanic communities are overrepresented among persons living with HIV/AIDS in the United States. Members of black and Hispanic communities are also overrepresented in the criminal justice; in terms of the epidemic, approximately one out of seven persons living with HIV/AIDS will pass through a U.S. correctional facility in any given year. A history of incarceration is associated with poor treatment outcomes for HIV illness. Improving the quality of HIV care in correctional facilities and in the communities to which incarcerated persons will return is imperative, as is effective interventions in incarcerated populations and communities. Having AIDS activists, scientists, and healthcare workers join in efforts to reform incarceration policies and practices will improve efforts to prevent and treat HIV/AIDS, particularly in communities that confront high rates of HIV/AIDS and incarceration.

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C-25 Neurocognitive Correlates of Chronological and Subjective Age Differences in Persons Living with HIV compared to those without HIV

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz034.187 ◽

2019 ◽

Vol 34 (6) ◽

pp. 1054-1054

Author(s):

M Kohli ◽

L Kamalyan ◽

E Pasipanodya ◽

R Moore ◽

S Letendre ◽

...

Keyword(s):

Successful Aging ◽

Well Being ◽

Future Research ◽

Subjective Age ◽

Persons Living With Hiv ◽

Hiv Serostatus ◽

Functioning Inventory ◽

The Difference ◽

Living With Hiv ◽

The Relationship

Abstract Objective Investigate the discrepancy between subjective and chronologic age by HIV-serostatus, and the association of this discrepancy with subjective neurocognitive functioning (NCF) and objective NCF. Methods One hundred nineteen persons living with HIV (PWLH) and 98 HIV-uninfected (HIV-) adults (Mage = 50.9; SDage = 7.9) completed a comprehensive neurobehavioral battery. Subjective age was assessed using a single-item question (i.e., “how old do you feel?”). The difference between chronologic and subjective age resulted in subjective age discrepancy scores (SADS). Subjective NCF was measured using the Patient’s Assessment of Own Functioning Inventory; objective NCF was measured using global demographically-corrected T-scores. Linear regressions examined the association between subjective and objective NCF with SADS, covarying for significant PLWH and HIV- group differences (i.e., education, sex, ethnicity, and lifetime Major Depressive Disorder). Results PLWH reported lower SADS (indicating closer correspondence between chronologic and subjective age) than their HIV- counterparts, who reported feeling much younger (p = .05; 95% CI: -5.4, .001). Among PLWH, better subjective NCF was significantly related to greater SADS (p = .0002; 95% CI: -.48, -.16). Objective NCF was not associated with SADS among persons with and without HIV. Conclusions Adults without HIV reported feeling younger than their chronologic age, whereas PLWH felt significantly closer to their chronologic age. SADS were negatively associated with only subjective NCF, among only PLWH. This suggests perceived cognitive functioning has a greater impact on psychological well-being among this group. Future research is warranted to delineate the relationship between HIV, subjective neurocognition, and psychosocial factors related to daily functioning to improve successful aging outcomes among this vulnerable population.

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Implications of Perceived Neighborhood Quality, Daily Discrimination, and Depression for Social Integration Across Mid- and Later Life: A Case of Person-Environment Fit?

The Gerontologist ◽

10.1093/geront/gnz103 ◽

2019 ◽

Vol 60 (4) ◽

pp. 661-671

Author(s):

Jeffrey E Stokes

Keyword(s):

Social Integration ◽

Successful Aging ◽

Later Life ◽

Well Being ◽

The United States ◽

Neighborhood Quality ◽

Social Community ◽

Random Intercept ◽

Person Environment Fit ◽

Age Range

Abstract Background and Objectives Integration in one’s social community may depend in part upon feeling safe and secure within one’s physical community, or neighborhood. Moreover, high-quality neighborhoods may serve as a supportive resource, potentially “buffering” against the harmful influence of experiences such as discrimination or depression that could otherwise erode adults’ sense of belonging. This study examines longitudinal associations of perceived neighborhood quality, daily discrimination, and depression with social integration among midlife and older adults, and tests whether perceived neighborhood quality is of increased importance with age and/or in the contexts of discrimination and depression. Research Design and Methods Multilevel random intercept models analyzed 6,016 observations of 3,102 individuals drawn from the 3 waves of the National Survey of Midlife Development in the United States (MIDUS, 1995–2014). Results Perceived neighborhood quality was associated with greater social integration throughout adulthood, though its impact was slightly attenuated with age. Moreover, depression was harmful for social integration across the age range, yet its influence was significantly buffered by perceived neighborhood quality. Daily discrimination was not associated with social integration, net of covariates. Discussion and Implications Findings underscore the importance of physical place and person-environment fit for social well-being throughout adulthood, and confirm the deleterious effects of depression for adults’ social integration. Further, results highlight perceived neighborhood quality as a critical component for successful “aging in place,” particularly as a social resource adults may call upon in the context of depression.

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Persons Living With HIV/AIDS: Employment as a Social Determinant of Health

Rehabilitation Research Policy and Education ◽

10.1891/2168-6653.30.1.4 ◽

2016 ◽

Vol 30 (1) ◽

pp. 4-31 ◽

Cited By ~ 7

Author(s):

Kenneth C. Hergenrather ◽

Robert J. Zeglin ◽

Liza Conyers ◽

Mark Misrok ◽

Scott D. Rhodes

Keyword(s):

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

The United States ◽

Social Determinant ◽

Employment Services ◽

Highly Active ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Social Determinant Of Health ◽

Hiv Aids

Purpose: For persons living with HIV/AIDS (PLWHA), the advent of highly active antiretroviral therapy has increased their longevity and quality of life. As HIV progresses, many PLWHA present declined domains of functioning that impede their ability to work. The authors explore employment as a social determinant of health to identify issues impacting employment outcomes for PLWHA.Methods: The authors reviewed the literature addressing HIV across the domains of mental health functioning, neurocognitive functioning, and physical function and employment.Results: When providing employment services to PLWHA, considerations for rehabilitation practitioners and educators include HIV/AIDS education, functional assessment, social support, considerations for women with HIV, highly active antiretroviral therapy (HAART), HIV/AIDS stigma, and employment resources for PLWHA.Conclusion: With more than 1.2 million PLWHA in the United States, and most of new infections among persons 25–44 years of age, the prevalence of PLWHA seeking employment and inclusive of the U.S. workforce will continue to increase. Proving employment services for PLWHA is a complex process that is best served by an integrative service approach.

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Social Determinates of Health Among Older Adults Living With HIV/AIDS

Innovation in Aging ◽

10.1093/geroni/igab046.1634 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 423-423

Author(s):

Erin Robinson ◽

Tonya Taylor

Keyword(s):

Mental Health ◽

Older Adults ◽

Successful Aging ◽

Insurance Coverage ◽

The United States ◽

Hiv Treatment ◽

People Living With Hiv ◽

Health Food ◽

Living With Hiv ◽

Hiv Aids

Abstract In the United States (U.S.), people aged 55 years and older make up 36% of people living with HIV/AIDS (PLWHA). Nearly 20% of new HIV infections occur among people aged 50+. While medical breakthroughs in HIV treatment have allowed PLWHA to live longer, healthier lives, structural conditions still exist that affect health outcomes of older adults living with HIV/AIDS (OALWHA). These conditions continue to disproportionately burden OALWHA, particularly older adults of color. Therefore, a greater understanding of the social determinates of health (SDH) is essential to continue making progress in HIV treatment, maintenance, and prevention. The U.S. Centers for Disease Control and Prevention (CDC) has highlighted several SDH among OALWHA, including: poverty, education, income, employment status, health insurance coverage, and housing. This symposium will highlight emerging research that examines several of these indicators among OALWHA. Using a variety of research methodologies, the five abstracts included in this symposium aim to address: 1) psychosocial risk factors of quality of life; 2) life instability and mental health; 3) institutional barriers and facilitators of successful aging; 4) determinants of engaging in advance care planning; and 5) a needs assessment of OALWHA, with particular emphasis on SDH. Results from this research identify several priority areas (such as housing instability, mental health, food insecurity, and isolation) for healthcare leaders to consider in targeting future policy, programming, and funding. Future initiatives are essential to help continue the progress in HIV/AIDS treatment and prevention, including addressing SDH among the aging population living with HIV/AIDS.

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