METHODS: This cross-sectional study analyzed data from older adults living with HIV who participated in the Ontario Cohort Study (OCS). The OCS is a community-governed, multi-site study that collects clinical and socio-behavioral information voluntarily from people living with HIV in clinical settings across the province of Ontario. The present study analyzed data from 383 participants (age 50-86) who completed extensive interviewer assisted questionnaires between September, 2007 and March, 2010. Using multiple linear regression, comparisons were analyzed between heterosexual men, gay/bisexual men (GBM) and all women on sociodemographic (age, income, education, marital status, race) positive (social support, mastery) and deleterious (maladaptive coping, stigma, cigarette smoking) health and psychosocial variables. The total standardized score of the SF-36 Mental Component Scale (MCS), which measures MHQOL, was the dependent variable.
RESULTS: Heterosexual men reported comparable MCS scores (M=45.90) as GBM (46.52); however, women reported significantly worse scores than both the male groups (M=44.24, p<.01), even after controlling for socio-demographic, psychosocial and health-related variables. Variables associated with better MCS scores included Black/African racial identity (p=.05), Emotional-Informational social support (p<.001), and mastery (p<.001); the latter two variables accounted for 25% of the variance in the fully adjusted model.
CONCLUSIONS AND IMPLICATIONS: Among older people living with HIV, we found that men, particularly GBM, reported higher mental health resiliency than did women. Additionally, having emotional as well as informational supports appear to increase the level of MHQOL among the sample. Having a Black/African racial identity was also associated with higher MHQOL. Given that women report poorer mental health, future research should examine mechanisms to advance the mental health resiliency of older women living with HIV. Since these findings are from cross-sectional data, research is needed to understand mechanisms through which these factors enhance MHQOL among older adults living with HIV. It may be useful to examine the mechanisms that have facilitated the enhanced resiliency among GBM as a way to determine practice and policy initiatives to maintain this resiliency among GBM as well as ways to advance this resiliency among all older adults living with HIV, particularly older women. Social workers who work with older adults living with HIV can use these findings to better understand the needs of the populations they serve and to consider interventions to support resiliency among these populations.
