Barcelona 2013
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| Abstract #39 - E-Posters English | ||||
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Session: 50.17: E-Posters English (Poster) on Sunday in Chaired by Authors: Presenting Author: Dr Patty Solomon - McMaster University, Canada |
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| Additional Authors: Dr. Jordi Casabona, Sra Cristina Sanclemente, Dra. Anna Esteve, Dra. Victoria Gonzalez, Grupo HIVITS TS, | ||||
| Aim: As people live longer with HIV there is a need for greater understanding of the challenges of aging with the episodic and stigmatizing nature of HIV and the resulting disability. Rehabilitation is defined as any services or providers that address the physical, cognitive, mental, and social health challenges among people living with HIV. The rehabilitation perspective compliments the biomedical perspective and shifts the focus to understanding the health consequences (or disability) of HIV and aging. The purpose of this research was to develop a theoretical model of disability that describes the health challenges experienced from the perspective of older adults living with HIV. | ||||
| Method / Issue: We conducted a qualitative grounded theory study and recruited men and women 50 years of age or older living with HIV to participate in in-depth interviews. Interviews included questions related to various aspects of disability. Interviews were audio-recorded, transcribed verbatim and analysed using a constructivist grounded theory approach. Recruitment and iterative analyses continued until data saturation. We then examined relationships between the themes and developed a preliminary model. Validity focus groups with a subset of the participants provided feedback on the initial model which informed the final model of disability. An Advisory Committee of people living with HIV and representatives from AIDS Service Organizations provided guidance on the overall process and interpretation of findings. | ||||
| Results / Comments: Twenty-nine men and 20 women with a mean age of 56 years and a mean number of years since diagnosis of 13.5 years participated in the study. The model of disability included uncertainty as a core component of the disability experience. Uncertainty was related to understanding the source of health challenges, whether health providers had knowledge and skills to manage age-related disability, financial uncertainty, availability of age appropriate housing, and concerns about who would provide care as one ages with HIV. Disability was experienced within the context of intrinsic (or personal) factors including positive living strategies and gender; and extrinsic (or external) factors such social supports and stigma. Time emerged as an overarching component of the model having an impact on disability. Chronological time, time since diagnosis, time on medication, time in the workplace, the sense of growing older faster and the episodic nature of HIV influenced the entire disability experience. | ||||
| Discussion: : This model highlights the complexities of aging with the episodic and unpredictable nature or HIV. It builds on existing disability models by highlighting the central role of uncertainty related to aging with HIV, and suggests health and social service providers have an important role in supporting older adults in addressing uncertainty with aging. The importance of time as an overarching component of the model reinforces the need for longitudinal research to understand the consequences and contributors to disability over time. | ||||
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