Challenges to meeting the HIV care needs of older adults in the rural South

Quinn, Katherine; John, Steven A.; Hirshfield, Sabina; Algiers, O.; O’Neil, Andrew M.; Petroll, Andrew E.; Walsh, Jennifer L.

doi:10.1016/j.ssmqr.2022.100113

Cited by 7 publications

(6 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Importantly, older rural PLH may face additional challenges accessing both case management services and supportive services due to long distances to care and support organizations and limited transportation options. Remotely delivered case management could improve access to services for rural older PLH, although HIV service providers will likely require additional resources to implement new services, especially given the existing strain on rural service providers identified in previous research 118,119 . Additional research may be useful to elucidate whether briefer case management services, delivered remotely, could be effective while requiring less time per client than do current case management standards.…”

Section: Discussionmentioning

confidence: 99%

“…113,114 to implement new services, especially given the existing strain on rural service providers identified in previous research. 118,119 Additional research may be useful to elucidate whether briefer case management services, delivered remotely, could be effective while requiring less time per client than do current case management standards. Additionally, policy solutions are needed to improve access to both home-based care and services, such as food banks, for rural older populations.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with quality of life, depressive symptoms, and perceived stress among rural older adults living with HIV in the United States

Walsh

John

Quinn

et al. 2022

The Journal of Rural Health

View full text Add to dashboard Cite

Purpose Rural older people living with HIV (PLH) in the United States are a population of growing size and significance. A better understanding of factors associated with quality of life (QOL), depressive symptoms, and stress in this population—especially modifiable factors—could inform future interventions. Methods Online or on paper, we surveyed 446 PLH aged 50+ residing in rural counties across the United States (Mage = 56, 67% male, 67% White, and 23% Black). Associations between social support, HIV stigma, satisfaction with medical care, discrimination in health care settings, and structural barriers and health‐related QOL, depressive symptoms, and perceived stress were assessed using multiple linear regressions. Findings Controlling for demographics, greater social support was associated with better QOL, fewer depressive symptoms, and less stress. Greater HIV stigma was associated with more depressive symptoms and stress. Satisfaction with care was associated with better QOL and less stress. Discrimination in medical settings was associated with lower QOL and more depressive symptoms and stress. Finally, experiencing more structural barriers was associated with lower QOL and more depressive symptoms and stress. Conclusions In addition to engagement in care and viral suppression, QOL and mental health are also critical considerations for rural older PLH. Increasing social support, reducing or providing skills to cope with HIV stigma, improving quality of care, reducing discrimination and stigma in medical settings, and reducing or mitigating the impact of structural barriers present potential targets for interventions aiming to improve the well‐being of older rural PLH.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors associated with quality of life, depressive symptoms, and perceived stress among rural older adults living with HIV in the United States

Walsh

John

Quinn

et al. 2022

The Journal of Rural Health

View full text Add to dashboard Cite

show abstract

“…Dramatic growth in older PLWH populations will create special challenges for southern cities with regards to providing adequate healthcare, housing, and social services for this special population (Quinn et al., 2022). Regardless of their geographic location, older PLWH may face many challenges that will require unique and innovative responses from both clinicians and public health professionals.…”

Section: Methodsmentioning

confidence: 99%

Management of HIV in the older adults: Clinical and public health challenge

Zdanowicz,

Valdes,

Salani

2024

Public Health Nursing

View full text Add to dashboard Cite

As a result of significant advances in antiretroviral therapy (ART), the number of people living with human immunodeficiency virus (PLWH) who are alive well into their senior years has increased significantly in recent years. While increased life expectancy is a highly desired outcome for PLWH, it brings with it a number of challenges that are only now starting to be understood and fully appreciated. These challenges include higher rates of co‐morbidities, polypharmacy, drug side effects, and cognitive deficits, as well as numerous psychosocial issues such as stigma, loneliness, and depression. Older PLWH also face challenges related to housing, health insurance, and long‐term care. This review will discuss many of the challenges faced by older PLWH and present clinical and public health responses with suggested interventions that may improve outcomes for this population.

show abstract

“…The lack of an intersectional lens has obscured the structural vulnerabilities created by systemic responses to race, gender, sexual identities, and socioeconomic status, hindering comprehensive solutions for diverse communities. (9)(10)(11) Applying an intersectional lens to understand social and structural determinants of health through a participatory community approach can inform the adaptation and implementation of targeted interventions, such as Community Health Workers (CHWs) to address the complex and interconnected factors contributing to HIV inequities.…”

Section: Introductionmentioning

confidence: 99%

St. Louis Enhancing Engagement and Retention in HIV/AIDS Care (STEER): a participatory intersectional needs assessment for intervention and implementation planning

Humphries,

Marotta,

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Missouri is one of seven priority states identified by the Ending the HIV Epidemic Initiative, and St. Louis contains almost half of the people living with HIV (PLWH) in Missouri. As St. Louis has a marked history of structural racism and economic inequities, we utilized the Intersectionality Based Policy Analysis (IBPA) framework to guide a participatory needs assessment for planning and program development. Methods The planning team included researchers, the lead implementer from our community partner, and two community representatives, and had biweekly 60-90 minute meetings for 18 months. The planning team discussed and approved all research materials, reviewed and interpreted results, and made decisions about outreach, recruitment, conduct of the needs assessment and development of the planned intervention. The needs assessment integrated information from existing data, (1) interviews with (a) PLWH (n=12), (b) community leaders (n=5), (c) clinical leaders (n=4), and (d) community health workers (CHWs) (n=3) and (e) CHW supervisors (n=3) who participated in a Boston University-led demonstration project on CHWs in the context of HIV and (2) focus groups (2 FG, 12 participants) with front line health workers such as peer specialists, health coaches and outreach workers. A rapid qualitative analysis approach was used for all interviews and focus groups. Results The IBPA was used to guide team discussions of team values, definition and framing of the problem, questions and topics in the key informant interviews, and implementation strategies. Applying the IBPA framework contributed to a focus on intersectional drivers of inequities in HIV services. The effective management of HIV faces significant challenges from high provider turnover, insufficient integration of CHWs into care teams, and organizational limitations in tailoring treatment plans. Increasing use of CHWs for HIV treatment and prevention also faces challenges. People living with HIV (PLWH) encounter multiple barriers such as stigma, lack of social support, co-morbidities, medication side effects and difficulties in meeting basic needs. Conclusions Addressing intersectional drivers of health inequities may require multi-level, structural approaches. We see the IBPA as a valuable tool for participatory planning while integrating community engagement principles in program and implementation design for improving HIV outcomes.

show abstract

Challenges to meeting the HIV care needs of older adults in the rural South

Cited by 7 publications

References 48 publications

Factors associated with quality of life, depressive symptoms, and perceived stress among rural older adults living with HIV in the United States

Factors associated with quality of life, depressive symptoms, and perceived stress among rural older adults living with HIV in the United States

Management of HIV in the older adults: Clinical and public health challenge

St. Louis Enhancing Engagement and Retention in HIV/AIDS Care (STEER): a participatory intersectional needs assessment for intervention and implementation planning

Contact Info

Product

Resources

About