What Helps Older People with HIV (PWH) Stay Healthy?

Background:

Significant advances in antiretroviral medications have enabled people with HIV (PWH) to experience near-normal longevity. Yet, the concurrent effects of combination antiretroviral therapy and aging on PWH’s health are still unclear. Research has shown the complexities of aging with HIV; for example, higher rates of comorbidities are prevalent among older PWH. It was found that hospitalizations among older PWH were more frequently related to heart diseases, liver-related diseases, pneumonia, and diabetes, rather than HIV alone. While researchers have been exploring HIV in older adults from a medical perspective, there is an urgent need to understand what older PWH themselves consider integral in maintaining health and how individual- and community-level factors can be incorporated in developing interventions.

Methods:

From a community-based participatory research study (n=40), participants who were 50 years of age or older at the time of interview were selected for this analysis (n=20; Mean age=55 years; range 50–60 years). The inclusion criteria consisted of: (1) previously established HIV primary medical care at an urban, academically-affiliated HIV clinic in the Southern United States and (2) currently living in the county where the study was conducted. Participants were recruited through word-of-mouth and flyers posted in targeted community locations and other community-based organizations. Moreover, information about the study was distributed at a clinic where all study participants received HIV primary medical care. Interviews were semi-structured and conducted face-to-face. Interviews were recorded, transcribed, coded, and triangulated through an iterative process by researchers and community members during team meetings.

Results:

In this sample (n=20), the majority of participants were male (75%) and Black (80%). There were four female participants and one transgender female. Participants represented 16 ZIP codes (17%) in the county and resided in diverse socioeconomic settings. Codes identified from interviews suggested pervasive strategies for older PWH to maintain their health included: (1) educating themselves to educate others (about HIV); (2) practicing safer sex; (3) eating healthy; (4) taking medicine as ordered and attend doctors’ appointments; (5) quitting smoking and drinking; (6) having a positive attitude and mindset; (7) staying active; and (8) getting involved in community.

Conclusions and implications:

The study results suggest that older PWH have identified what works for them to stay healthy. They utilized what is available to them internally (e.g., positive mindset) and externally (e.g., medical care). To further promote these self-initiated, self-identified ways to stay healthy, peer group support should be more actively utilized for older PWH. A peer’s message serves as a powerful communication tool. Moreover, there should be efforts to provide increased educational services to older PWH about HIV and aging-related information. Local community-based organizations (e.g., HIV agencies, churches) can help provide condoms, food boxes for healthy eating, social support or treatment specific (e.g., Alcoholics Anonymous) meetings, and reminders for medicines and doctors’ appointments. As older PWH want to stay active and give back to their communities, opportunities for such activities should be organized to encourage social networking and a sense of belonging, which can help them stay positive about their HIV health.