IDEAS home Printed from https://ideas.repec.org/a/wly/eldpol/v1y2020i1p69-95.html

Is There no Place for Us? The Psychosocial Challenges and Rewards of Aging with HIV

Author

Listed:
  • Charles A Emlet
  • Mark Brennan‐Ing

Abstract

According to the Centers for Disease Control and Prevention (CDC), nearly half a million people aged fifty years and older have human immunodeficiency virus (HIV) in the US. This population will continue to grow and some estimates suggest that approximately 70% of all persons with HIV (PWH) in the US will be 50 and over by 2030. This pattern is found globally, as access to antiretroviral therapy becomes widespread. This population includes newly infected older adults and long‐term survivors aging with HIV. This article reviews the challenges and opportunities for older PWH, focusing primarily on psychosocial issues. While the growth of this population testifies to the success of HIV treatments, older PWH encounter numerous difficulties in later life, including high rates of multi‐morbidity, behavioral health issues, HIV stigma, and social isolation. Many older PWH face difficulties finding care in fragmented systems poorly aligned for the dual challenges of aging and having HIV. We address these structural problems and misalignment with eight policy recommendations to improve access to care and support healthy aging. These recommendations fall into three main categories: 1) increased recognition of this population in planning and the National HIV/AIDS Strategy, 2) improved access to programs through the Ryan White and Older American's Act programs, and 3) better surveillance data on this population globally. Short of a cure, the dramatic increase in the population of older PWH will continue for the foreseeable future. It is the duty of advocates, gerontologists, health and social service providers, and policymakers to meet the needs of those growing older with HIV. Según los Centros para el Control y la Prevención de Enfermedades (CDC), casi medio millón de personas mayores de cincuenta años tienen el virus de la inmunodeficiencia humana (VIH) en los Estados Unidos. Esta población continuará creciendo y algunas estimaciones sugieren que aproximadamente el 70 por ciento de todas las personas con VIH (PWH) en los EE. UU. Tendrán 50 años o más para 2030. Este patrón se encuentra en todo el mundo, a medida que el acceso a la terapia antirretroviral se generaliza. Esta población incluye adultos mayores recién infectados y sobrevivientes a largo plazo que envejecen con VIH. Este artículo revisa los desafíos y las oportunidades para las personas con discapacidad mayores, centrándose principalmente en cuestiones psicosociales. Si bien el crecimiento de esta población atestigua el éxito de los tratamientos contra el VIH, los PWH mayores se enfrentan a numerosas dificultades en la edad adulta, incluidas las altas tasas de morbilidad múltiple, problemas de salud conductual, estigma del VIH y aislamiento social. Muchos PWH mayores enfrentan dificultades para encontrar atención en sistemas fragmentados mal alineados para los desafíos duales del envejecimiento y el VIH. Abordamos estos problemas estructurales y la desalineación con ocho recomendaciones de políticas para mejorar el acceso a la atención y apoyar el envejecimiento saludable. Estas recomendaciones se dividen en tres categorías principales: 1) un mayor reconocimiento de esta población en la planificación y la Estrategia Nacional contra el VIH / SIDA, 2) un mejor acceso a los programas a través de los programas de la Ley Ryan White y Older American's Act, y 3) mejores datos de vigilancia sobre esta población globalmente A falta de una cura, el aumento dramático en la población de personas mayores con PWH continuará en el futuro previsible. Es deber de los defensores, gerontólogos, proveedores de servicios sociales y de salud y formuladores de políticas satisfacer las necesidades de las personas mayores con VIH. 根据疾病预防控制中心（CDC），美国近50万50岁及以上的成人患有人类免疫缺陷病毒（HIV）。这一人口将继续增加，并且一些预测暗示美国HIV携带者（PWH）总数中近70%将在2030年达到50岁及以上。随着抗逆转录病毒疗法的可及性得以扩散，该模式在全球都是如此。这一人口包括新感染的中老年人和长期伴随HIV衰老的生存者。本文审视了中老年PWH的挑战与机遇，主要聚焦于心理社会问题。尽管这一人口的增长证实了HIV治疗的成功，但中老年PWH在之后的生活中面临诸多困难，包括多种疾病的高发病率、行为健康问题、HIV耻辱、以及社会隔离。许多中老年PWH在分散的医疗卫生体系中寻求护理时面临困难，这些体系无法良好应对老龄化与HIV的双重挑战。我们提出八项政策建议应对这些结构性问题和不一致，以期提高护理可及性并支持健康老龄化。这些建议分为三个主要类型：1) 在规划国家艾滋病毒/艾滋病战略时提高对这一人口的重视；2) 通过瑞安•怀特项目和《美国老年人法案》项目提高相关项目的可及性；3) 提升全球在这一人口上的监测数据。鉴于无法痊愈，中老年PWH人口的显著增加情况将在可预见的未来中继续存在。满足那些携带HIV衰老的人口的需求，是倡导者、老年学家、卫生与社会服务提供者、以及决策者的职责。

Suggested Citation

  • Charles A Emlet & Mark Brennan‐Ing, 2020. "Is There no Place for Us? The Psychosocial Challenges and Rewards of Aging with HIV," Journal of Elder Policy, John Wiley & Sons, vol. 1(1), pages 69-95, June.
    • Handle: RePEc:wly:eldpol:v:1:y:2020:i:1:p:69-95
    DOI: 10.18278/jep.1.1.4
    as

    Download full text from publisher

    File URL: https://doi.org/10.18278/jep.1.1.4
    Download Restriction: no
    File URL: https://libkey.io/10.18278/jep.1.1.4?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Christine S Autenrieth & Eduard J Beck & Dominik Stelzle & Christoforos Mallouris & Mary Mahy & Peter Ghys, 2018. "Global and regional trends of people living with HIV aged 50 and over: Estimates and projections for 2000–2020," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-11, November.
    2. Peter Piot & Michael Bartos & Peter D. Ghys & Neff Walker & Bernhard Schwartländer, 2001. "The global impact of HIV/AIDS," Nature, Nature, vol. 410(6831), pages 968-973, April.
    3. Cahill, S. & Valadéz, R., 2013. "Growing older with HIV/AIDS: New public health challenges," American Journal of Public Health, American Public Health Association, vol. 103(3), pages 7-15.
    4. Nicole Maestas & Kathleen J. Mullen & Alexander Strand, 2013. "Does Disability Insurance Receipt Discourage Work? Using Examiner Assignment to Estimate Causal Effects of SSDI Receipt," American Economic Review, American Economic Association, vol. 103(5), pages 1797-1829, August.
    5. Cahill, S.R. & Mayer, K.H. & Boswell, S.L., 2015. "The Ryan White HIV/AIDS Program in the age of health care reform," American Journal of Public Health, American Public Health Association, vol. 105(6), pages 1078-1085.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Phan Sok & Mary V. Seeman & Rosane Nisenbaum & James Watson & Sean B. Rourke & on behalf of the PSHP Team, 2021. "Four-Year Trajectories of Health-Related Quality of Life in People Living with HIV: Impact of Unmet Basic Needs across Age Groups in Positive Spaces, Healthy Places," IJERPH, MDPI, vol. 18(22), pages 1-16, November.
    2. Sergi Jiménez-Martín & Arnau Juanmarti Mestres & Judit Vall Castelló, 2019. "Great Recession and disability insurance in Spain," Empirical Economics, Springer, vol. 56(5), pages 1623-1645, May.
    3. Fevang, Elisabeth & Hardoy, Inés & Røed, Knut, 2013. "Getting Disabled Workers Back to Work: How Important Are Economic Incentives?," IZA Discussion Papers 7137, IZA Network @ LISER.
    4. Pierpaolo Giannoccolo & Silvia Platoni, 2023. "Temporary versus permanent disability: A dynamic incentives model," Metroeconomica, Wiley Blackwell, vol. 74(4), pages 698-721, November.
    5. Garrett Anstreicher, 2021. "Does increasing health care access reduce disability insurance caseloads? Evidence from the rural United States," Health Economics, John Wiley & Sons, Ltd., vol. 30(4), pages 786-802, April.
    6. Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy & Wong, Albert, 2020. "Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival," Journal of Health Economics, Elsevier, vol. 73(C).
    7. Dalsgaard, Søren & Nielsen, Helena Skyt & Simonsen, Marianne, 2014. "Consequences of ADHD medication use for children's outcomes," Journal of Health Economics, Elsevier, vol. 37(C), pages 137-151.
    8. Epaulard, Anne & Zapha, Chloé, 2022. "Bankruptcy costs and the design of preventive restructuring procedures," Journal of Economic Behavior & Organization, Elsevier, vol. 196(C), pages 229-250.
    9. Maclean, J. Catherine & Pichler, Stefan & Ziebarth, Nicolas R., 2020. "Mandated Sick Pay: Coverage, Utilization, and Welfare Effects," IZA Discussion Papers 13132, IZA Network @ LISER.
    10. Koning Pierre & Vethaak Heike, 2021. "Decomposing Employment Trends of Disabled Workers," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 21(4), pages 1217-1255, October.
    11. Francisca Vargas Lopes & Pieter Bakx & Sam Harper & Bastian Ravesteijn & Tom Van Ourti, 2022. "The effects of supported housing for individuals with mental disorders," Health Economics, John Wiley & Sons, Ltd., vol. 31(S2), pages 115-133, October.
    12. Hjellset Alne, Ragnar, 2018. "Economic incentives, disability insurance and labor supply," Working Papers in Economics 2/18, University of Bergen, Department of Economics, revised 14 Jun 2018.
    13. Michelle Yin & Garima Siwach & Dajun Lin, 2023. "Vocational Rehabilitation Services and Labor Market Outcomes for Transition‐Age Youth with Disabilities in Maine," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(1), pages 166-197, January.
    14. Liebert, Helge, 2019. "Does external medical review reduce disability insurance inflow?," Journal of Health Economics, Elsevier, vol. 64(C), pages 108-128.
    15. Chen, Daniel L. & Levonyan, Vardges & Yeh, Susan, 2016. "Policies Affect Preferences: Evidence from Random Variation in Abortion Jurisprudence," IAST Working Papers 16-58, Institute for Advanced Study in Toulouse (IAST).
    16. Bíró, Anikó & Elek, Péter, 2020. "Job loss, disability insurance and health expenditure," Labour Economics, Elsevier, vol. 65(C).
    17. Anna Aizer & Joseph J. Doyle, 2015. "Juvenile Incarceration, Human Capital, and Future Crime: Evidence from Randomly Assigned Judges," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(2), pages 759-803.
    18. Rehwald, Kai & Rosholm, Michael & Rouland, Bénédicte, 2018. "Labour market effects of activating sick-listed workers," Labour Economics, Elsevier, vol. 53(C), pages 15-32.
    19. Katie M. Jajtner & Sophie Mitra & Christine Fountain & Austin Nichols, 2020. "Rising Income Inequality Through a Disability Lens: Trends in the United States 1981–2018," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 151(1), pages 81-114, August.
    20. Su Liu & David C. Stapleton, "undated". "Longitudinal Statistics on Work Activity and Use of Employment Supports for New Social Security Disability Insurance Beneficiaries," Mathematica Policy Research Reports fe4441401f1549fc8ef75bad7, Mathematica Policy Research.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:eldpol:v:1:y:2020:i:1:p:69-95. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.