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      Aging With HIV in the Era of Antiretroviral Treatment : Living Conditions and the Quality of Life of People Aged Above 50 Living With HIV/AIDS in Switzerland

      research-article
      , PhD 1 , , lic. phil. 1
      Gerontology and geriatric medicine
      SAGE Publications
      aging, HIV, older, quality of life, living conditions

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          Abstract

          The aim of this cross-sectional study was to identify the living conditions and the quality of life of people aged more than 50 who were living with HIV in Switzerland. Participants were consecutively sampled through different HIV-specific sites. Seventy-two HIV-positive persons filled in an anonymous standardized questionnaire, either paper-pencil or online. Descriptive and inferential statistics were calculated. Quality of life was rated quite high ( M = 14.9, SD = 4.14). The multivariate regression analyses showed that mental and physical health problems, long-term living with HIV, having a high degree of needed support, and financial problems decreased quality of life, and perceived available social support was an important predictor in maintaining quality of life. In addition to current offers to support mental health and social networks, efforts to integrate people of working age into the labor market and efforts to reduce stigma and the social marginalization of older HIV-positive people should be fostered.

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          Most cited references16

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          Depression and thoughts of suicide among middle-aged and older persons living with HIV-AIDS.

          This study examined the prevalence and characteristics of suicidal ideation among middle-aged and older persons who have HIV infection or AIDS. A total of 113 subjects older than age 45 who had HIV-AIDS were recruited from AIDS service organizations in Milwaukee, Wisconsin, and New York City. Participants completed confidential questionnaires covering suicidal ideation, emotional distress, quality of life, coping, and social support. Twenty-seven percent of respondents reported having thought about taking their own life in the previous week. Those who had thought about suicide reported greater levels of emotional distress and poorer health-related quality of life than those who had not considered suicide. They were also significantly more likely to use escape and avoidance strategies for coping with HIV infection and less likely to use positive-reappraisal coping. Those who had thought about suicide also were more likely to have disclosed their HIV status to the people close to them, and yet they perceived receiving significantly less social support from friends and family. With the exceptions of physical functioning and coping strategies, differences between those who had contemplated suicide and those who had not remained unchanged after controlling for symptoms of depression. Persons who are in midlife and older and are living with HIV-AIDS experience significant emotional distress and thoughts of suicide, suggesting a need for targeted interventions to improve mental health and prevent suicide.
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            The aging HIV/AIDS population: fragile social networks.

            Social support becomes an increasingly critical resource for people as they age. In New York City, 25% of all people living with HIV/AIDS are over age 50, and 64% are over age 40. This study sample (n=160) reflects current HIV/AIDS epidemiology, with 34% females and 89% people of color. This study provides a detailed profile of this growing, aging cohort and their social networks. Our study finds this growing group of aging adults is isolated from informal networks due to the stigma of HIV/AIDS and ageism. Typically, partners and family members are key sources of informal support, but only 1/3 of respondents had a partner and 71% lived alone. This group relies heavily on friends, many of whom are also HIV-positive. Participants were in primary care and many (86%) utilized Medicaid. The fragile networks of these older adults will be challenged by age-related comorbidities. Without traditional caregivers, these aging adults with HIV/AIDS will have an immense impact on healthcare delivery and community-based programs.
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              Association of age and comorbidity with physical function in HIV-infected and uninfected patients: results from the Veterans Aging Cohort Study.

              HIV clinical care now involves prevention and treatment of age-associated comorbidity. Although physical function is an established correlate to comorbidity in older adults without HIV infection, its role in aging of HIV-infected adults is not well understood. To investigate this question we conducted cross-sectional analyses including linear regression models of physical function in 3227 HIV-infected and 3240 uninfected patients enrolled 2002-2006 in the Veterans Aging Cohort Study-8-site (VACS-8). Baseline self-reported physical function correlated with the Short Form-12 physical subscale (ρ = 0.74, p < 0.001), and predicted survival. Across the age groups decline in physical function per year was greater in HIV-infected patients (β(coef) -0.25, p < 0.001) compared to uninfected patients (β(coef) -0.08, p = 0.03). This difference, although statistically significant (p < 0.01), was small. Function in the average 50-year old HIV-infected subject was equivalent to the average 51.5-year-old uninfected subject. History of cardiovascular disease was a significant predictor of poor function, but the effect was similar across groups. Chronic pulmonary disease had a differential effect on function by HIV status (Δβ(coef) -3.5, p = 0.03). A 50-year-old HIV-infected subject with chronic pulmonary disease had the equivalent level of function as a 68.1-year-old uninfected subject with chronic pulmonary disease. We conclude that age-associated comorbidity affects physical function in HIV-infected patients, and may modify the effect of aging. Longitudinal research with markers of disease severity is needed to investigate loss of physical function with aging, and to develop age-specific HIV care guidelines.
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                Author and article information

                Journal
                Gerontol Geriatr Med
                Gerontol Geriatr Med
                GGM
                spggm
                Gerontology and geriatric medicine
                SAGE Publications (Sage CA: Los Angeles, CA )
                2333-7214
                15 March 2016
                Jan-Dec 2016
                : 2
                : 2333721416636300
                Affiliations
                [1 ]University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
                Author notes
                [*]Sibylle Nideröst, Professor, Institute for Integration and Participation, School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600 Olten, Switzerland. Email: sibylle.nideroest@ 123456fhnw.ch
                Article
                10.1177_2333721416636300
                10.1177/2333721416636300
                5119792
                28138489
                7dcc8256-5f6c-4326-b2fb-3b49cd69726a
                © The Author(s) 2016

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License ( http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 9 November 2015
                : 27 January 2016
                : 2 February 2016
                Categories
                Article
                Custom metadata
                January-December 2016

                aging,hiv,older,quality of life,living conditions
                aging, hiv, older, quality of life, living conditions

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