[Viva] FW: CATIE News - Examining resilience and aging in HIV infection

[Kath Webster]

Here`s an optimistic study!!

CATIE News - Examining resilience and aging in HIV infection

As people age they naturally experience a variety of health challenges.
Long-term infection with HIV carries not only physical and medical burdens
but also poses psychosocial issues from time to time. All of these factors
can affect HIV-positive people's quality of life and ability to manage their
health and may ultimately have an impact on their survival.

Some HIV-positive people display an ability to cope and
thrive-resilience-despite having to carry the burdens of a complex chronic
health condition. As part of a study, researchers at the University of
Washington in Seattle have been interviewing HIV-positive people who display
resilience. Their findings have helped identify a strength among some
HIV-positive people that the research team described as successful aging.
This finding may be important, as it has the potential to inform
psychosocial support services for HIV-positive people, particularly as they
grow older.

Study details

Researchers recruited 25 participants and conducted structured interviews.
Their basic profile was as follows:

*	eight females and 17 males
*	age - between 50 and 70 years
*	major ethno-racial groups - 60% White, 36% Black

Results-Emerging themes

In analysing their data, the researchers found that participants' responses
to questions could be divided into seven major themes, which the team
labeled as follows:

*	self-acceptance
*	optimism
*	will to live
*	generativity (caring about younger generations of people)
*	self-management
*	relational living (formal and informal support from other people)
*	independence

We now explore some of these themes.

Self-acceptance

According to the researchers, several participants found that
self-acceptance was "central to overcoming the negative effects of HIV/AIDS
and the complexities of aging with such a stigmatizing disease."

One of the participants said: "It has been fine for me because I just accept
growing older. I don't [want] to act like or think that I'm still 25."

Another participant explained his feelings to researchers by saying: "Be who
you are, and be glad you're still here."

The researchers found that self-acceptance helped participants to realize
their strengths and limitations. In turn, this allowed participants to "move
forward with their lives, rather than remaining stuck and mired on regrets
from prior actions and behaviors."

Optimism

A large majority of participants had a positive outlook on aging with HIV.
They continued to have goals about the future and wanted to age well in the
years ahead. According to the study team, most participants disclosed that
it required some effort on their part "not to have living with HIV/AIDS
substantially impact future plans and feelings of well-being." Indeed, many
participants envisioned living with HIV as just one of several barriers they
had to overcome, as they had successfully done in the past.

One interviewee said: "You know that there's gonna be hurdles in anybody's
life. You know, you have to learn to get over the hurdle. If everybody let
every hurdle bring them down we wouldn't have half the people here that we
have now."

One woman outlined her approach to aging to the researchers: "It's not
really a big deal to me. I mean, I take my medicines; I go on with my life.
I don't think about the AIDS anymore."

Will to live

Several participants stated strongly that thanks to advances in HIV
treatment they now expect to live for several more decades. One woman told
interviewers that she was grateful for having lived to be 57 years, but, she
said: "I've had a good life and I'm already looking at the second half of
life. So, it does sadden me, but you know, no one leaves the planet without
dying."

Generativity

Ten participants told interviewers that they wanted to give something back
to their communities and to the larger society. One woman said that older
HIV-positive people have important experience and a responsibility to share
that and educate younger people regardless of their HIV status. "We can give
them advice [because] we've been through what they're going through now,"
she said.

Self-management

Researchers found that many participants raised issues related to caring for
themselves, such as taking medicines as prescribed, having a balance of
sleep, rest and activity and eating a healthy diet. As participants took
greater control of their lives, researchers found that they were better able
to manage HIV disease.

One 72-year-old woman said: "I maintain a very healthy lifestyle, I diet,
exercise, the whole thing, and doing well is what counts. So I'm in pretty
good shape for being this far along with the diagnosis."

The woman posed the following question for other HIV-positive people: "What
are you doing as an individual to cope with this condition? I think that it
is how a person handles it (HIV infection) himself. You could either give in
to it or you can fight it."

Relational living

The study team used this term to describe the relationships participants
formed with other people and organizations. Many participants found their
families to be a source of support. One man found his grandchildren
particularly helpful because they accepted him unconditionally.

Participants who were in long-term relationships found them to be a great
source of support. One man said: "I've been in a relationship for 21 years
and because of that have not had to deal with a lot of the loneliness that
is a very large part of being gay and older."

Some people found their support networks through religion, theatre or other
groups to be particularly helpful.

Researchers found that participants' social connections made them "feel
valued as a person and.gave them a sense of contributing and feelings of
self-worth while knowing that they are not facing this situation alone."

Independence

About half of the participants were living alone. They expressed feelings of
being self-reliant and self-supporting and this helped them feel "in control
of aging and HIV disease."

Summary

All participants in the study displayed a number of psychological strengths.
The study team found that participants were able to turn negative
experiences into opportunities for personal growth and development.
Furthermore, interviewees also expressed feelings of hopefulness. The
researchers said that although participants were aging with HIV, their
attitudes and statements made it clear that "it was possible to retain
meaning in life, psychological well-being and maintenance of valued
activities and relationships."

Implications

The study team encourages gerontologists, psychologists, social workers,
counsellors and health-care practitioners to integrate an assessment of
strengths into their strategies for helping older HIV-positive adults.

Additional studies are needed to explore the presence/absence of resilience
in more HIV-positive people. The researchers suggests that such studies
could be used to help develop strategies for enabling resilience "to promote
successful aging" among HIV-positive people.

Sean R. Hosein

REFERENCE:

Emlet CA, Tozay S, Raveis VH. "I'm Not Going to Die from the AIDS":
Resilience in Aging with HIV Disease. The Gerontologist. 2011
Feb;51(1):101-11.

 

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