Gender Differences in Support Preferences Among Older Adults with HIV

Purpose: Half of those living with HIV will be age 50 or older by 2015. As one grows older with chronic illness, the availability of social networks to provide support becomes crucial. Previous research has found that older adults with HIV have friend-centered social networks, consisting of other HIV-positive individuals. These findings suggest that many lack access to adequate social support (Brennan et. al., 2010, Shippy & Karpiak, 2005; Nichols, et al., 2002). The Hierarchical Compensatory Model of Social Support (Cantor, 1979), proposes that older adults prefer to receive assistance from those closest to them such as spouses and children. When those sources of support are unavailable, individuals turn to other, more distant family members, friends and only finally to formal community-based services. This paper examines support preferences among older adults with HIV as well as gender differences in these preferences. Methods: Cross-sectional survey using a convenience sample (n=180) of HIV-positive clients over 50 of an AIDS Service Organization. As part of a larger survey, individuals were asked to respond to thirteen items on whom, if anyone, they would most likely turn to given a series of hypothetical situations that included items on instrumental, emotional and informational support. Support preference choices included spouses and children, other family, friends/neighbors, formal institutions, and “no one” or “not sure”. Data analysis included descriptive statistics and gender differences were tested with chi-square analyses. Results: There were several significant gender differences in the preference for support elements. Men preferred self-reliance, followed by friends if they felt sick or dizzy while women preferred a spouse/partner or child, (X²(5)=18.03, p=.01). A similar gender difference was observed for assistance in getting to a medical appointment(X²(5)=20.23, p=.001). For both men and women friends were most commonly selected if one was lonely and needed to talk, but for men this constituted over fifty-percent of responses. Among women, it was split more evenly between friends and family, with a third selecting friends and a quarter close family for this type of emotional support (X²(5)=11.18, p=.05). Men showed a preference for friends if they needed someone to look after their apartment if they were in the hospital, while women for close family (X²(5)=12.27, p=.05). For men needing help to pay a medical bill (X²(5)=11.50, p=.05), or help filling out a form(X²(5)=12.91, p=.05), self-reliance was the preferred choice followed by formal services, while women favored formal services on both these items. Implications: Older men with HIV report a tendency to not seek support from family in many situations, reflecting the lack of close significant others in their support networks. Older women with HIV tend to rely more on family, although there is still a heavy reliance on friends. Many older adults living with HIV lack the traditional social supports available to most other older adults. As this population ages, the need for both instrumental and emotional assistance will grow. As such, community based organization and aging service providers must reach out to this population and assume a larger role in providing formal supports.