An investigation of factors associated with the health and well-being of HIV-infected or HIV-affected older people in rural South Africa

This paper examines changes in households with older people in a northern rural area of KwaZulu Natal province, South Africa, between January 2000 and January 2002. The focus is the impact of adult deaths, especially those from AIDS, on the living arrangements of older people. The longitudinal data are from the Africa Centre Demographic Information System. In 2000, 3,657 older people (women aged 60 years or older, men 65 years or older) were resident in the area, and 3,124 households had at least one older member. The majority (87%) of older people lived in three-generation households. Households with older people were significantly poorer, more likely to be headed by a woman, and in homesteads with poorer quality infrastructure than households without older members. By January 2002, 316 (8%) of the older people in the sample had died. Of all the households with an older person, 12 per cent experienced at least one adult death from AIDS. The paper shows that older people, particularly those living alone or with children in the absence of other adults, were living in the poorest households. They were also coping with an increasing burden of young adult deaths, the majority of which were attributable to AIDS.

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Reproductive decision-making among postpartum HIV-infected women in rural South Africa

International Journal of STD & AIDS ◽

10.1177/0956462418766932 ◽

2018 ◽

Vol 29 (9) ◽

pp. 908-916 ◽

Cited By ~ 1

Author(s):

Deborah L Jones ◽

Violeta J Rodriguez ◽

Suat Babayigit ◽

Antonio Chahine ◽

Stephen M Weiss ◽

...

Keyword(s):

South Africa ◽

Decision Making ◽

Mother To Child Transmission ◽

Child Transmission ◽

Rural South ◽

Factors Associated ◽

Reproductive Decision ◽

Reproductive Decision Making ◽

Mother To Child ◽

Rural South Africa

Despite pregnancy spacing recommendations to optimize health outcomes among mothers and neonates, unplanned pregnancy in sub-Saharan Africa is common among women living with human immunodeficiency virus (HIV) (WLHIV). This study examined factors associated with reproductive decision-making among WLHIV to inform pregnancy-planning interventions. WLHIV in rural South Africa (n = 165) were assessed at 12 months postpartum. The relative importance of factors associated with reproductive decision-making was estimated. Women were a mean of 28 years old (SD = 5.71). Risk of mother-to-child transmission (MTCT) of HIV (Mean = 0.43; SD = 0.33) had the greatest impact on decision-making, followed by partners’ desires (M = 0.22; SD = 0.18), family preferences (M = 0.18; SD = 0.13), and community opinion (M = 0.17; SD = 0.13). MTCT was most important to women with greater HIV knowledge. However, WLHIV who had been diagnosed with HIV for a longer time placed more emphasis on partner preference and community opinion, and less importance on MTCT risk. Prevention of mother-to-child transmission (PMTCT) was less important to women experiencing intimate partner violence and those with depression. Findings highlight the need for tailored, focused interventions to support the unique circumstances of WLHIV and support the inclusion of families and/or partners in the counseling process. Results underscore the need for perinatal preconception counseling for women during routine HIV care.

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Factors associated with antiretroviral treatment initiation amongst HIV-positive individuals linked to care within a universal test and treat programme: early findings of the ANRS 12249 TasP trial in rural South Africa

AIDS Care ◽

10.1080/09540121.2016.1164808 ◽

2016 ◽

Vol 28 (sup3) ◽

pp. 39-51 ◽

Cited By ~ 25

Author(s):

Sylvie Boyer ◽

Collins Iwuji ◽

Andréa Gosset ◽

Camelia Protopopescu ◽

Nonhlanhla Okesola ◽

...

Keyword(s):

South Africa ◽

Antiretroviral Treatment ◽

Treatment Initiation ◽

Hiv Positive ◽

Rural South ◽

Factors Associated ◽

Test And Treat ◽

Universal Test ◽

Universal Test And Treat ◽

Rural South Africa

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Chronic multimorbidity among older adults in rural South Africa

BMJ Global Health ◽

10.1136/bmjgh-2018-001386 ◽

2019 ◽

Vol 4 (4) ◽

pp. e001386 ◽

Cited By ~ 8

Author(s):

Angela Y Chang ◽

Francesc Xavier Gómez-Olivé ◽

Collin Payne ◽

Julia K Rohr ◽

Jennifer Manne-Goehler ◽

...

Keyword(s):

South Africa ◽

Mental Disorders ◽

Psychological Functioning ◽

Well Being ◽

Sociodemographic Factors ◽

Multiple Chronic Conditions ◽

Cross Sectional ◽

Rural South ◽

Rural South Africa

IntroductionThe rapid ageing of populations around the world is accompanied by increasing prevalence of multimorbidity. This study is one of the first to present the prevalence of multimorbidity that includes HIV in the complex epidemiological setting of South Africa, thus filling a gap in the multimorbidity literature that is dominated by studies in high-income or low-HIV prevalence settings.MethodsOut of the full sample of 5059 people aged 40+, we analysed cross-sectional data on 10 conditions from 3889 people enrolled in the Health and Ageing in Africa: A longitudinal study of an INDEPTH Community in South Africa (HAALSI) Programme. Two definitions of multimorbidity were applied: the presence of more than one condition and the presence of conditions from more than one of the following categories: cardiometabolic conditions, mental disorders, HIV and anaemia. We conducted descriptive and regression analyses to assess the relationship between prevalence of multimorbidity and sociodemographic factors. We examined the frequencies of the most prevalent combinations of conditions and assessed relationships between multimorbidity and physical and psychological functioning.Results69.4 per cent (95% CI 68.0 to 70.9) of the respondents had at least two conditions and 53.9% (52.4–55.5) of the sample had at least two categories of conditions. The most common condition groups and multimorbid profiles were combinations of cardiometabolic conditions, cardiometabolic conditions and depression, HIV and anaemia and combinations of mental disorders. The commonly observed positive relationships between multimorbidity and age and decreasing wealth were not observed in this population, namelydue to different epidemiological profiles in the subgroups, with higher prevalence of HIV and anaemia in the poorer and younger groups, and higher prevalence of cardiometabolic conditions in the richer and older groups. Both physical functioning and well-being negatively associated with multimorbidity.DiscussionMore coordinated, long-term integrated care management across multiple chronic conditions should be provided in rural South Africa.

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Who cares? Implications of care-giving and -receiving by HIV-infected or -affected older people on functional disability and emotional wellbeing

Ageing and Society ◽

10.1017/s0144686x13000615 ◽

2013 ◽

Vol 35 (1) ◽

pp. 169-202 ◽

Cited By ~ 12

Author(s):

M. NYIRENDA ◽

M. EVANDROU ◽

P. MUTEVEDZI ◽

V. HOSEGOOD ◽

J. FALKINGHAM ◽

...

Keyword(s):

South Africa ◽

Older People ◽

Functional Ability ◽

Functional Disability ◽

Emotional Wellbeing ◽

Rural South ◽

Care Givers ◽

Care Giving ◽

The Relationship ◽

Rural South Africa

ABSTRACTThis paper examines how care-giving to adults and/or children and care-receiving is associated with the health and wellbeing of older people aged 50+ in rural South Africa. Data used are from a cross-sectional survey adapted from World Health Organization's Study on Global Ageing and Adult Health (SAGE) conducted in 2009/10 in rural South Africa. Bivariate statistics and multivariate logistical regression were used to assess the relationship between care-giving and/or care-receiving with functional disability, quality of life or emotional wellbeing, and self-rated health status, adjusted for socio-demographic factors. Sixty-three per cent of 422 older people were care-givers to at least one young adult or child; 27 per cent of older people were care-givers due to HIV-related reasons in young adults; 84 per cent of participants were care-recipients mainly from adult children, grandchildren and spouse. In logistic regressions adjusting for sex, age, marital status, education, receipt of grants, household headship, household wealth and HIV status, care-giving was statistically significantly associated with good functional ability as measured by ability to perform activities of daily living. This relationship was stronger for older people providing care-giving to adults than to children. In contrast, care-givers were less likely to report good emotional wellbeing; again the relationship was stronger for care-givers to adults than children. Simultaneous care-giving and -receiving was likewise associated with good functional ability, but about a 47 per cent lower chance of good emotional wellbeing. Participants who were HIV-infected were more likely to be in better health but less likely to be receiving care than those who were HIV-affected. Our findings suggest a strong relationship between care-giving and poor emotional wellbeing via an economic or psychological stressor pathway. Interventions that improve older people's socio-economic circumstances and reduce financial hardship as well as those that provide social support would go some way towards mitigating this relationship.

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Social Conditions and Disability Related to the Mortality of Older People in Rural South Africa

World Health & Population ◽

10.12927/whp.2015.24266 ◽

2014 ◽

Vol 15 (4) ◽

pp. 34-43

Author(s):

Xavier Gómez-Olivé ◽

Margaret Thorogood ◽

Philippe Bocquier ◽

Paul Mee ◽

Kathleen Kahn ◽

...

Keyword(s):

South Africa ◽

Older People ◽

Social Conditions ◽

Rural South ◽

Rural South Africa

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The social context of children's nutritional status in rural South Africa 1

Scandinavian Journal of Public Health ◽

10.1080/14034950701355700 ◽

2007 ◽

Vol 35 (69_suppl) ◽

pp. 107-117 ◽

Cited By ~ 33

Author(s):

Sangeetha Madhavan ◽

Nicholas Townsend

Keyword(s):

South Africa ◽

Nutritional Status ◽

Financial Support ◽

Well Being ◽

Ethnographic Study ◽

Current Status ◽

Rural South ◽

Rural South Africa ◽

Height For Age ◽

Weight For Age

Aim: To investigate the relationship between children's nutritional status and a series of measures capturing both the current status and the lifetime history of their connection with adult caregivers in the Agincourt sub-district of rural South Africa. Methods: Using data on a sample of 202 children from a recent ethnographic study of children's social connections and well-being, the authors (1) compare height for age and weight for age to an accepted international standard and (2) conduct bivariate analyses of the relationships between selected measures of social connection and extreme deviations below expected weight and expected height. Results: Fitted curves for weight for age and height for age fall between the 5th and 50th percentiles of CDC growth curves. Compromised nutrition, defined as being more than two standard deviations below expected height or weight, is associated with the death or non-co-residence of the mother, and with the absence of financial support from the father. The co-residence of maternal female kin as substitutes for the mother do not fully compensate for her absence. Conclusions: The findings highlight the importance of parental living arrangements, parental financial support, birth order and the composition of sibling sets, and lifetime residential patterns in facilitating access to nutrition.

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