Methods: This study utilized a subsample of subjects from the Caring and Aging with Pride study (CAPP). CAPP is a national survey of LGBT older adults, age 50 and over, recruited from eleven sites throughout the United States. This cross-sectional study analyzed data from participants in the CAPP study, utilizing data from 233 participants (age 50+) who self identified as being diagnosed with HIV/AIDS. All data was analyzed using multiple regression models. A regression analysis was conducted to test the impacts of risk factors (HIV progression, victimization, loneliness, depression and limitations of activities) and protective factors (social support, self-efficacy and an available caregiver) on physical health-related quality of life, controlling for age, income, education and gender. A second analysis was conducted for mental health-related quality of life.
Results: The sample ranged in age from 50-86 (M= 62.84, SD = 7.31). The majority (98%) were male; 31% reported less than $20,000 annual household income; 62% had a four-year college or higher degree. The majority were non-Hispanic white (74%); 12% were Hispanic; 7% were African American. A bivariate correlational analyses indicated that each of the risk and protective factors were significantly associated with physical and mental health-related QOL. According to multiple regression analysis with physical health as a dependent variable, being limited in daily activities (b=-20.84; p<.001), depression (b=-9.22; p<.01) and receiving care (b=-9.17; p<.01) were significantly associated with lower physical health scores. While not significant, victimization (b=-0.38; p=0.08) and HIV disease progression (b=-4.19; p=0.08) were also associated with poorer scores on the physical health measure. The final model accounted for 52% of the variance in physical health-related quality of life. With mental health-related quality of life, limited activities (b=-11.85; p<.001), depression (b=-14.45; p<.001) and loneliness (b=-5.24; p<.01) were significantly associated with poorer mental health. Self-efficacy (b=4.86; p<.001) was found to be a significant protective factor. The final model accounted for 67% of the variance in mental health-related quality of life.
Implications: Findings suggest the importance of healthy internal mechanisms (mastery, mental health), as well as physical factors (limited activities and requiring care) as factors associated with both physical and mental health-related quality of life among older adults living with HIV/AIDS. Additional studies and analyses are needed to determine specific ways to improve mental health, improve self-efficacy and decrease loneliness in this population.
