Age, stress, and isolation in older adults living with HIV

Abstract

People living with HIV (PLWH) have increasingly longer life spans. This age group faces different challenges than younger PLWH, which may include increased stress and social isolation. The purpose of this study was to determine if the age and sex of PLWH is associated with measures of physiologic stress, perceived stress and social isolation. In this cross-sectional study, we enrolled 102 PLWH equally into four groups divided by age (< or > 50 years) and gender. Participants completed well-validated survey measurements of stress and isolation, and their heart rate variability over 60 minutes was measured by Holter monitor. The mean (standard deviation) Perceived Stress Scale score was 17.4 (6.94), mean visual analog stress scale score was 3.51 (2.79), and mean Hawthorne Friendship Scale score, a measure of social isolation, was 17.03 (4.84). Mean heart rate variability expressed as the standard deviation of successive N-N intervals was 65.47 (31.16) msec. In multivariable regression models that controlled for selected demographic variables, there was no relationship between the Perceived Stress Scale and age (coefficient=−0.09, p=−.23) or female gender (coefficient=−0.12, p=0.93); however, there was a modest relationship between female gender and stress using the visual analog stress scale (coefficient=1.24, p=0.05). Perceived Stress was negatively associated with the Hawthorne Friendship score (coefficient=−0.34, p=0.05). Hawthorne Friendship score was positively associated with younger age (coefficient=0.11, p=0.02). Age was the only independent predictor of physiologic stress as measured by heart rate variability (coefficient=−1.3, p<0.01). Our findings suggest that younger PLWH may experience more social isolation; however, age-related changes in heart rate variability do not appear to be related to perceived stress or social isolation. Future longitudinal research is required to more thoroughly understand this relationship and its impact on the health of PLWH.

Reflections on living with HIV over time: exploring the perspective of HIV-infected women over 50

“…Another recent study examining stress and social isolation among older PLWHA found that participants who were age 50 or older reported less perceived stress and social isolation when compared to participants 49 years or younger (Webel et al, 2014). These findings and those from the current study may be best understood from a framework of adult development, such as the model of strength and vulnerability integration (SAVI; Charles, 2010), which, in brief, posits that with age, individuals are better able to regulate their emotional experiences as a result of improvements in the use of “attentional strategies, appraisals, and behaviors”.…”

Successful Coping in Urban, Community-Dwelling Older Adults With HIV

“…The authors concluded that older adults' experience-based wisdom, patience, contentment, less-threatening perceptions of illness, and lower resentment about having a serious chronic condition explained better psychological outcomes compared to younger adults with HIV. Older adults in a recently published study of stress, social isolation, and age in low-income African American men and women with HIV actually reported less social isolation than those younger than 50 years of age (Webel et al, 2014). …”

Understanding of the elderly attached to the Family Health Strategy about the HIV/AIDS infection

“…to minimize this situation, it is essential to revisit the way in which information is transmitted in order to correct the misconceptions about HIV/AIDS and its modes of transmission [11][12][13].…”