Resources Utilized By Older People with HIV (PWH) to Stay Emotionally Healthy: Lessons from Community-Based Participatory Research

Background: Prior research has examined how emotional health affects general well-being of people with HIV (PLH) and has elucidated factors that pertain to emotional health. For instance, poor emotional health, as evidenced by depression and anxiety, negatively affects quality of life. Stigma and social isolation negatively affect PWH’s emotional health. Prior research found that community-level factors are intricately intertwined with various factors that influence wellbeing of older PWH. A piece missing from the literature that requires further attention is which resources older PWH access and utilize to overcome negative factors and stay emotionally healthy. It is important to hear from participants of community-based participatory research on their lived experience of how they maintain their emotional wellbeing.

Methods:

From community-based participatory research (n=40), participants who were at least 50-years-old at the time of interview were selected for this analysis (n=20). Eligibility criteria included: (1) established HIV primary medical care at an urban, academically-affiliated HIV clinic in the Southern United States and (2) currently living within the county where the study was conducted. Participants were recruited through word-of-mouth and flyers posted in community-based organizations and other targeted community locations. Moreover, information about the study was distributed at a clinic where all study participants received HIV primary care services. 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), majority of participants were male (75%) and Black (80%). The mean age was 55 years (range 50–60 years). Participants resided in 16 ZIP codes (17%) in one county of a Southern state and represented diverse backgrounds. Emergent themes identify four types of resources utilized to maintain their emotional health:1) spirituality, 2) family support, 3) clinic support, and 4) internal locus of control. Participants stated that their spirituality provided them with protection, strength, blessings, and purpose in life. Social support from family members, if available, were noted to bring comfort to participants. A local clinic also provided social support and was reported to be a place where older PWH could share their feelings and concerns. Belief that they have control over what happens to them aided participants in staying positive.

Conclusions:

To stay emotionally healthy, older PWH found resources within themselves (i.e., spirituality, internal locus of control) as well as externally (i.e., support from families and/or clinics). As the link between emotional health and physical health has been established by prior research, there is an opportunity to leverage one’s available community resources to help improve emotional health, especially for older PWH. Helping professionals may need to discuss 1) integration of the practice or regaining of spirituality as an emotional health strategy, 2) enhancement of social support through families, friends, and clinical interventions, and 3) methods for assisting PLWH in developing a sense of control over their own lives and HIV health. It will be important to assess where older PWH’s strengths lie, internally or externally, and employ a strength-based approach to optimize emotional health.