OLDER ADULTS WITH HIV: WHAT YOU NEED TO KNOW Panel Discussion: The - - PowerPoint PPT Presentation
OLDER ADULTS WITH HIV: WHAT YOU NEED TO KNOW Panel Discussion: The War Against HIV/AIDS Rages On Building Successful Academic Partnerships to Achieve Health Equity Forum Atlanta Clinical and Translational Science Institute Community Engagement
Mark Brennan-Ing, PhD
ACRIA Center on HIV and Aging and New York University College of Nursing, New York, NY
Panel Discussion: The War Against HIV/AIDS Rages On Building Successful Academic Partnerships to Achieve Health Equity Forum Atlanta Clinical and Translational Science Institute Community Engagement Research Program (CERP) Morehouse School of Medicine, Atlanta, GA May 29, 2015
1 United States Senate Special Committee on Aging. HIV over Fifty:
Exploring the New Threat. [Web cast]. May 12, 2005. Available at http://aging.senate.gov/hearing_detail.cfm?id=270655&.
2 Brooks et al. (2012). (Am J Public Health. Published online ahead
The HIV population is graying; adults 50 and older will comprise over half of those living with HIV by 2015 (CDC, 2013).
0% 5% 10% 15% 20% 25% 30% 35% 40%
<13 13–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50+ 2008 2009 2010
% of All People with HIV in the US by Age Group: 2008-2010
CDC Surveillance Data
Mortality (x 1000)
Source: NYC Dept of Health & Mental Hygiene, 2004
PWHA (x 10,000)
1 2 3 4 5 6 7 8 9 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02
% of People with HIV Age 50 and Older 2009-2010
19 % and less 20-29 % 30-39 % 40 % and more
5000 10000 15000 20000 25000 30000
34%
Adapted from ART-CC, Lancet 2008;372:293-99 – Slide Courtesy of A. Justice
Adapted from ART-CC, Lancet 2008;372:293-99 – Slide Courtesy of A. Justice
>50% of Deaths Attributed to Non-AIDS Events
HIV/STI-related Age-related Mental/Neuro/Other
10 20 30 40 50 60
0-1 2 3 4 5 6+
NHANES ROAH
Severe (23+) 43% Moderate (16-22) 20% Not Depressed (1 to 15) 37%
20 40 60 80
Parent Child Sibling Other Relative Friend
41.2 54 78.7 50.4 69.4 27.2 37.7 43.8 31.4 66.1
Living Functional
A functional network member is someone in at least weekly phone/monthly in-person contact and can be reasonably assumed to provide assistance in times of need (Cantor & Brennan, 2000)
Domain Type Family Friends
Instrumental Shop/Run Errands 37.8 37.1 Keep House/Prepare Meals 32.3 23.6 Take/Drive Places 30.0 31.6 Mail/Correspondence 26.9 18.1 Manage Money/Pay Bills 23.7 16.5 Emotional Advice on Big Decisions 48.3 54.4 Talk to When Feeling Low 62.5 68.2 Talk About Personal Matters 59.0 64.9 Negative Reluctant to Talk 32.6 29.7 Made Upset/Hurt Feelings 35.7 33.7 Refused to Help 20.6 20.6
assistance compared with friends, but this is less evident among older PWHA
levels of emotional support, but support from friends has not compensated for absent family support
Compensatory Model, older adults with HIV frequently turn to government and community- based services for their needs
Formal Services Friends & Neighbors Distant Family Close Family
Cantor’s (1978) Hierarchical Compensatory Theory of Social Support posits that we turn first for help to those closest in our networks (spouse/partners & children), then to more distant relatives, friends, neighbors, and lastly to government and community-based
hierarchical manner
20