Older people had significantly better mental functioning, fewer depressive symptoms, and better treatment self-efficacy.

[Guest guest]

Yes! Finally some good news about some of us old farts. What they do not say is that people with older age in HIV are also long term survivors that have educated themselves and have learned how to better manage their HIV. Yes, we are taking more medications for aging related comorbidities but we seem to be functioning OK and be happier."Although older HIV-positive people are living with more comorbidities," the researchers

concluded, "they are more likely to be taking HIV medications and less likely to have AIDS." Older people had significantly better mental functioning, fewer depressive symptoms, and better treatment self-efficacy. RSubject: NATAP/IAC: Aging Survey in US

Survey

Challenges Assumptions About Aging With HIV in United States

XIX International AIDS Conference, July 22-27, 2012, Washington, DC

Mark Mascolini

Contrary to common assumption in some quarters, HIV-positive US residents in

their 60s had better mental health and less depression than younger people with

HIV, according to results of a 1293-person survey [1]. Fewer 60-and-over

seniors had AIDS, and their physical functioning proved as robust as that of

younger HIV-positives.

The survey is cross-sectional, it focused on a convenience sample of adults

with HIV, and analyses did not factor in education or income. But the findings

may raise caution about assuming that all 60-and-older HIV-positives suffer an

undue burden of psychosocial and physical deficits. The study also offers one

of the first looks at a 60-plus HIV cohort rather than considering everyone

over 50 "older."

The overall study involved 2182 HIV-positive people recruited at HIV clinics

and service organizations in the United States, Canada, Puerto Rico, Namibia,

China, and Thailand from February 2010 to July 2011. This analysis focused on

1293 US participants in three age groups: 687 (53%) from 40 to 49 years old,

514 (40%) from 50 to 59, and 92 (7%) 60 and older.

Similar proportions of the 40-to-49 group, the 50-to-59 group, and the 60-plus

group were men (71%, 73%, and 79%). The two younger groups had a slightly

higher proportion of blacks (47% and 52% versus 37%), a lower proportion of whites

(26% and 26% versus 38%), and a similar proportion of Hispanics (20%, 14%,

15%). A higher proportion of 60-plus participants had non-HIV medical

conditions (87% versus 71% in 50-to-59s and 64% in 40-to-49s), and a higher

proportions of 60-plus people were taking antiretrovirals (91%) than were

50-to-59s (82%) or 40-to-49s (81%). But a slightly lower proportion of the

oldest group had an AIDS diagnosis (40%) than did 50-to-59s (46%) or 40-to-49s

(52%).

The researchers used the Social Capital scale to estimate participants'

community involvement, neighborhood connections, relations with friends and

family, role limitations due to health issues, and social functioning

limitations due to mental health problems. They evaluated depression with the

nondiagnostic CES-D screening tool. And they assessed treatment self-efficacy

with HIV-ASES, which gauges an HIV-positive person's confidence in carrying out

health-related behaviors like keeping appointments and taking medications.

Compared with 40-to-49s, the 60-plus group and 50-to-59s notched a

significantly better social capital score (81.5 in both older groups versus

78.5 in the youngest group, P =

0.008). Physical functioning was equivalent across the three groups: 42.7 in

60-plus people, 41.3 in 50-to-59s, and 42.6 in 40-to-49s.

Treatment self-efficacy was significantly higher in 60-and-older people (100.5)

than in 50-to-59s (96.8) or 40-to-49s (91.3) (P = 0.000), and the oldest group had the best mental functioning

scores (50.8 versus 45.4 in 50-to-59s and 43.6 in 40-to-49s) (P = 0.000). People 60 and older had a

significantly lower depressive symptom score (14.8) than did 50-to-59s (20.5)

and 40-to-49s (22.2) (P = 0.000).

"Although older HIV-positive people are living with more

comorbidities," the researchers concluded, "they are more likely to

be taking HIV medications and less likely to have AIDS." Older people had

significantly better mental functioning, fewer depressive symptoms, and better

treatment self-efficacy.

In further analyses, the investigators plan to control for variables such as

race and education, although these three age groups were not greatly imbalanced

racially. The researchers did not speculate about selection bias, which may be

impossible to eliminate in a survey like this: HIV-positive people who survive

into their 60s are more likely to have better overall health than those who

die, and survivors may also have better coping skills and social support

systems.

Reference

1. Nokes K, Sefcik E, MO, et al. Getting older while living with HIV in

the United States. XIX International AIDS Conference. July 22-27, 2012.

Washington, DC. Abstract THPDD0201.