Facing uncertainty – ageing with HIV

Aging with HIV: a model of disability.

Solomon P, O'Brien K, Wilkins S, Gervais N. J Int Assoc Provid AIDS Care. 2014 Aug 22. pii: 2325957414547431. [Epub ahead of print]

The purpose of this qualitative study was to develop a theoretical model describing the disability experienced by older adults living with HIV. Forty nine HIV positive men and women over the age of 50 years participated in in-depth qualitative interviews. Transcribed interviews were analyzed using grounded theory techniques. Uncertainty or worrying about the future was at the core of the model. Components of disability including symptoms and impairments, difficulties with day to day activities and challenges to social participation were experienced in the context of extrinsic or environmental factors (social support, stigma) and intrinsic contextual factors (positive living strategies, age). Time was an overarching component of the model. The model suggests areas for interventions to prevent or reduce disability related to the consequences of aging with HIV and improve overall quality of life.

 Abstract access 

Editor’s notes: This paper is a very welcome addition to the growing body of research on HIV and ageing. Time is highlighted in the findings. Time has been regained (because treatment has kept people alive to grow old) and time is moving too fast (as individuals fear accelerated ageing because of HIV). The authors also highlight the centrality of uncertainty in the lives of the 49 people interviewed. Uncertainty is central to ageing. No-one of us knows quite how well we may remain as we age. However, the interaction between HIV and the ageing process is an added layer of uncertainty. The average age of people in this study was only 56, so they were relatively young, older people. We can expect worries over adequate social support and managing increasing ill-health and disability, will increase as people age. The authors urge us to look at the impact of HIV on older people’s quality of life as a whole, in the design of programmes. This paper is a timely reminder of the social, mental and physical burden HIV continues to impose on people’s lives.

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