Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-20T02:50:40.169Z Has data issue: false hasContentIssue false

‘I'm happy in my life now, I'm a positive person’: approaches to successful ageing in older adults living with HIV in Ontario, Canada

Published online by Cambridge University Press:  30 August 2016

CHARLES A. EMLET*
Affiliation:
Social Work Program, University of Washington, Tacoma, USA.
LESLEY HARRIS
Affiliation:
Kent School of Social Work, Louisville, Kentucky, USA.
CHARLES FURLOTTE
Affiliation:
School of Social Work, McMaster University, Hamilton, Canada.
DAVID J. BRENNAN
Affiliation:
Factor-Inwentash Faculty of Social Work, University of Toronto, Canada.
CHRISTINA M. PIERPAOLI
Affiliation:
Alabama Research Institute on Aging, University of Alabama, USA.
*
Address for correspondence: Charles A. Emlet, University of Washington, Tacoma, 1900 Commerce St., Campus Box 358425, Tacoma, WA 98402-5825, USA E-mail: caemlet@u.washington.edu

Abstract

Worldwide approximately 3.6 million people aged 50 and older are living and ageing with the human immunodeficiency virus (HIV). Few studies have explored successful ageing from the insider perspective of those living well and ageing with HIV. This study draws upon the lived experience and wisdom of older, HIV-positive adults living in Ontario, Canada in order to understand their views and strategies for successful ageing. This qualitative study involved semi-structured interviews with 30 individuals age 50 years and older who are HIV-positive. Purposive sampling techniques were used to recruit individuals who shared their experiences of successful ageing. Constructivist grounded theory coding techniques were used for analysis. Themes related to successful ageing included resilience strategies and challenges, social support and environmental context. Stigma and struggles to maintain health were identified as impediments to successful ageing. Models of successful ageing must take into account the potential for a subjective appraisal of success in populations suffering from chronic and life-threatening illnesses including HIV. Practitioners can draw upon organically existent strengths in this population in order to provide intervention development for older adults around the world who are struggling to manage their HIV.

Type
Articles
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brennan, D. J., Emlet, C., Brennenstuhl, S. and Rueda, S. 2013. Socio-demographic profile of older adults with HIV/AIDS: gender and sexual orientation differences. Canadian Journal on Aging, 32, 1, 3143.CrossRefGoogle ScholarPubMed
Capeau, J. 2011. Premature aging and premature age-related comorbidities in HIV-infected patients: facts and hypotheses. Clinical Infectious Diseases, 53, 11, 1120–6.Google Scholar
Centers for Disease Control and Prevention (CDC) 2013. Diagnoses of HIV infection among adults aged 50 years and older in the United States and dependent areas, 2007–2010. HIV Surveillance Supplemental Report, 18, 3, 170. Available online at http://www.cdc.gov/hiv/pdf/statistics_2010_HIV_Surveillance_Report_vol_18_no_3.pdf.Google Scholar
Charmaz, K. 2014. Constructing Grounded Theory. Second edition, Sage, Thousand Oaks, California.Google Scholar
Dentato, M. P., Orwat, J., Spira, M. and Walker, B. 2014. Examining cohort difference and resilience among the aging LGBT community: implications for education and practice among an expansively diverse population. Journal of Human Behavior and the Social Environment, 24, 3, 316–28.CrossRefGoogle Scholar
Emlet, C. A. 2006 a. ‘You're awfully old to have this disease’: experiences of stigma and ageism in adults 50 years and older living with HIV/AIDS. The Gerontologist, 46, 6, 781–90.Google Scholar
Emlet, C. A. 2006 b. An examination of the social networks and social isolation in older and younger adults living with HIV/AIDS. Health & Social Work, 31, 4, 299308.Google Scholar
Emlet, C. A., Brennan, D. J., Brennenstuhl, S., Rueda, S., Hart, T. A. and Rourke, S. B. 2015. The impact of HIV-related stigma on older and younger adults living with HIV disease: does age matter? AIDS Care, 27, 4, 520–8.Google Scholar
Emlet, C. A., Fredriksen-Goldsen, K. I. and Kim, H.-J. 2013. Risk and protective factors associated with health-related quality of life in older gay and bisexual men living with HIV disease. The Gerontologist, 53, 6, 963–72.Google Scholar
Emlet, C. A., Tozay, S. and Raveis, V. 2011. ‘I'm not going to die from the AIDS’: resilience in aging with HIV disease. The Gerontologist, 51, 1, 101–11.Google Scholar
Erlandson, D. A., Harris, E. L., Skipper, B. L. and Allen, S. D. 1993. Doing Naturalistic Inquiry: A Guide to Methods. Sage, Newbury Park, California.Google Scholar
Fabbre, V. D. 2015. Gender transitions in later life: a queer perspective on successful aging. The Gerontologist, 55, 1, 144–53.Google Scholar
Fredriksen-Goldsen, K. I., Emlet, C. A., Kim, H.-J., Muraco, A., Erosheva, E., Goldsen, J. and Hoy-Ellis, C. 2013. The physical and mental health and lesbian, gay male and bisexual (LGB) older adults: the role of key health indicators and protective factors. The Gerontologist, 53, 4, 644–75.Google Scholar
Fredriksen-Goldsen, K. I., Kim, H.-J., Emlet, C. A., Muraco, A., Erosheva, E. A., Hoy-Ellis, C. P., Goldsen, J., Petry, H. 2011. The Health Report: Resilience and Disparities Among Lesbian, Gay, Bisexual and Transgender Older Adults. Institute for Multigenerational Health, Seattle, Washington.Google Scholar
Fredriksen-Goldsen, K. I., Kim, H.-J., Shiu, C., Goldsen, J. and Emlet, C. A. 2015. Successful aging among LGBT older adults: physical and mental health-related quality of life by age group. The Gerontologist, 55, 1, 154–68.Google Scholar
Glaser, B. G. 1978. Theoretical Sensitivity: Advances in the Methodology of Grounded Theory. Sociology Press, Mill Valley, California.Google Scholar
Gooding, P. A., Hurst, A., Johnson, J. and Tarrier, N. 2012. Psychological resilience in young and older adults. International Journal of Geriatric Psychiatry, 27, 3, 262–70.Google Scholar
Greene, R. R. and Conrad, A.P. 2012. Resilience: basic assumptions and terms. In Greene, R. R. (ed.), Resiliency: An Integrated Approach to Practice, Policy and Research. NASW Press, Washington DC, 2962.Google Scholar
Guest, G. and MacQueen, K. (eds) 2008. Handbook for Team-based Qualitative Research. AltaMira Press, Lanham, Maryland, 205–26.Google Scholar
Heckman, T. G. and Halkitis, P. N. 2014. Biopsychosocial aspects of HIV and aging. Behavioral Medicine, 40, 3, 81–4.Google Scholar
High, K. P., Brennan-Ing, M., Clifford, D. B., Cohen, M. H., Currier, J., Deeks, S. G., Deren, S., Effors, R. B., Gebo, K., Goronzy, J. J., Justice, A. C., Landay, A., Levin, J. Miotti, P. G., Munk, R. J., Nass, H., Rinaldo, C. R. Jr, Shilpak, M. G., Tracy, R., Valcour, V., Vance, D. E., Walston, J. D. and Volberging, P. 2012. HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH Office of AIDS Research by the HIV and Aging Working Group. Journal of Acquired Immune Deficiency Syndrome, 60, supplement, S118.Google Scholar
Holstein, J. F. and Gubrium, J. A. 1995. The Active Interview. Sage, Thousand Oaks, California.Google Scholar
Hontelez, J. A., de Vlas, S. J., Baltussen, R., Newell, M. L., Bakker, R., Tanser, F., Lurie, M. and Bärnighausen, T. 2012. The impact of antiretroviral treatment on the age composition of the HIV epidemic on sub-Saharan Africa. AIDS, 26, supplement 1, S19–30.Google Scholar
Kahana, E. and Kahana, B. 2001. Successful aging among people with HIV/AIDS. Journal of Clinical Epidemiology, 54, 12, supplement 1, S53–6.Google Scholar
Lohse, N., Hansen, A. B., Pedersen, G., Kronborg, G., Gerstoft, J., Sorensen, H. T., Vaeth, M. and Obel, N. 2007. Survival of persons with and without HIV infection in Denmark, 1995–2005. Annals of Internal Medicine, 146, 2, 8795.Google Scholar
Luborsky, M. R. 1994. The identification and analysis of themes and patterns. In Gubrium, J. F. & Sankar, A. (Eds.), Qualitative Methods in Aging Research (pp. 189210). Thousand Oaks, CA: Sage.Google Scholar
Martin, P., Kelly, N., Kahaha, B., Kahana, E., Willcox, B. J., Willcox, D. C. and Poon, L. W. 2015. Defining successful aging: a tangible or elusive concept? The Gerontologist, 55, 1, 1225.CrossRefGoogle ScholarPubMed
Masten, J. 2007. Aging with HIV/AIDS: experience of gay men in late middle age . Dissertation, New York University, New York.Google Scholar
Moore, R. C., Moore, D. J., Thompson, W. K., Vahia, I. V., Grant, I. and Jeste, D. V. 2013. A case-controlled study of successful aging in older HIV-infected adults. Journal of Clinical Psychiatry, 74, e417–23.Google Scholar
Murphy, P. J. and Hevey, D. 2013. The relationship between internalized HIV-related stigma and posttraumatic growth. AIDS and Behavior, 17, 5, 1809–18.CrossRefGoogle Scholar
Negin, J. and Cumming, R. G. 2010. HIV infection in older adults in sub-Saharan Africa: extrapolating prevalence from existing data. Bulletin of the World Health Organization, 88, 847–53.Google Scholar
Negin, J., Nyirenda, M., Seeley, J. and Mutevedzi, P. 2013. Inequality in health status among older adults in Africa: the surprising impact of anti-retroviral treatment. Journal of Cross-cultural Gerontology, 28, 4, 491–3.CrossRefGoogle ScholarPubMed
Nobre, N. R., Kylmä, J. and Kirsi, T. 2012. ‘I live quite a good balance life’: a pilot study of the life experiences of ageing individuals living with HIV. Nursing Research and Practice. Volume 2012, Article ID 128108, 8 pages doi: 10.1155/2012/128108 (this is an online only journal)Google Scholar
Nyirenda, M., Chatterji, S., Falkingham, J., Mutevedzi, P., Hosegood, V., Evandrou, M., Kowal, P. and Newell, M.-E. 2012. An investigation of factors associated with the health and well-being on HIV-infected or HIV-affected older people in rural South Africa. BMC Public Health, 12, 259.Google Scholar
Padgett, D. K. 2008. Qualitative Methods in Social Work Practice. Second edition, Sage, Thousand Oaks, California.Google Scholar
Pathai, S., Bajillan, H., Landay, A. L. and High, K. P. 2014. Is HIV a model of accelerated or accentuated aging? Journals of Gerontology: Biological Sciences and Medical Sciences, 69A, 7, 833–42.Google Scholar
Public Health Agency of Canada 2014. HIV and AIDS in Canada: Surveillance Report to December 31st, 2013. Available online at http://www.phacaspc.gc.ca/aidssida/publication/survreport/2013/dec/assets/pdf/hiv-aids-surveillence-eng.pdf [Accessed 11 January 2015].Google Scholar
Pruchno, S., Heid, A. R. and Genderson, M. W. 2015. Resilience and successful aging: aligning complementary constructs using a life course approach. Psychological Inquiry, 26, 2, 200–7.Google Scholar
Romo, R. D., Wallhagen, M. I., Yourman, L., Yeung, C. C., Eng, C. Micco, G., Pérez-Stable, E. J. and Smith, A.K. 2013. Perceptions of successful aging among diverse elders with late-life disability. The Gerontologist, 53, 6, 939–49.CrossRefGoogle ScholarPubMed
Rowe, J. W. and Kahn, R. L. 1998. Successful Aging. Dell Publishers, New York.Google Scholar
Rowe, J. W. and Kahn, R. L. 2015. Successful aging 2.0: conceptual expansions for the 21st century. Journals of Gerontology: Psychological Sciences and Social Sciences, 70B, 4, 593–6.Google Scholar
Rubinstein, R. L. and de Medeiros, K. 2015. ‘Successful aging,’ gerontological theory and neoliberalism: a qualitative critique. The Gerontologist, 55, 1, 3442.Google Scholar
Scrimshaw, E. W. and Siegel, K. 2003. Perceived barriers to social support from family and friends among older adults with HIV/AIDS. Journal of Health Psychology, 8, 6, 732–52.Google Scholar
Shippy, R. A., Cantor, M. H. and Brennan, M. 2004. Social networks of aging gay men. Journal of Men's Studies, 13, 1, 107–20.Google Scholar
Smith, G. C. and Hayslip, B. Jr 2012. Annual Review of Gerontology & Geriatrics. Volume 32: Emerging Perspectives on Resilience in Adulthood and Later Life. Springer, New York.Google Scholar
Stewart, D. D. and Yuen, T. 2011. A systematic review of resilience in the physically ill. Psychosomatics, 52, 3, 199209.Google Scholar
Strauss, A. and Corbin, J. 1998. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Second edition, Sage, Thousand Oaks, California.Google Scholar
UNAIDS 2011. World AIDS Day Report 2011. How to Get to Zero. Faster. Smarter. Better. UNAIDS, Geneva.Google Scholar
UNAIDS 2013. HIV and Aging. A Special Supplement to the UNAIDS Report on the Global AIDS Epidemic. UNAIDS, Geneva.Google Scholar
Van Wagenen, A., Driskell, J. and Bradford, J. 2013. ‘I'm still raring to go’: successful aging among lesbian, gay, bisexual, and transgender older adults. Journal of Aging Studies, 27, 1, 114.Google Scholar
Vance, D. E., Brennan, M., Enah, C., Smith, G. L. and Kaur, J. 2011. Religion, spirituality and older adults with HIV: critical personal and social resources for an aging epidemic. Clinical Interventions in Aging, 6, 101–9.Google Scholar
Vance, D. E., Struzick, T. C. and Masten, J. 2008. Hardiness, successful aging and HIV: implications for social work. Journal of Gerontological Social Work, 51, 3/4, 260–83.CrossRefGoogle ScholarPubMed
Wild, K., Wiles, J. L. and Allen, R. E. S. 2013. Resilience: thoughts on the value of the concept for critical gerontology. Ageing & Society, 33, special issue 1, 137–58.Google Scholar