Navigating life with HIV as an older adult on the Kenyan coast: perceived health challenges seen through the biopsychosocial model

Abstract

Background : Kenya, like many sub-Saharan African countries (SSA), is experiencing a rise in the number of HIV infected adults aged at least 50 years (recognized as older adults living with HIV [OALWH]). This trend has created a subgroup of vulnerable older adults demanding a prompt response in research, policy, and practice to address their complex and transitioning needs. Unfortunately, little is known about the health and wellbeing of these adults in Kenya. As such, we explore the experiences of OALWH and key stakeholders at the coast of Kenya to understand the health challenges facing the OALWH. Material and methods : We utilized the biopsychosocial model to explore views from 34 OALWH and 22 stakeholders (11 health care providers and 11 primary caregivers) on the physical, mental, and psychosocial health challenges of ageing with HIV in Kilifi County, Kenya, between October and December 2019. Data were drawn from semi-structured in-depth interviews, which were audio-recorded and transcribed. A framework approach was used to synthesize the data. Results : Symptoms of common mental disorders (e.g. stress, worry, thinking too much), comorbidities (especially ulcers/hyperacidity, hypertension, visual and memory difficulties), somatic symptoms (especially pain/body aches, fatigue, and sleep problems), financial difficulties, stigma, and discrimination were viewed as common across the participants. Suicidal ideation and substance use problems (especially ' mnazi ' – the local palm wine and 'ugoro' – snuff) were also raised. There was an overlap of perceived risk factors across the three health domains, such as family conflicts, poverty, lack of social support, stigma, and the presence of comorbid health complaints. Conclusion : Our findings provide a preliminary understanding of challenges, using the biopsychosocial model, facing OALWH in a low-literacy Kenyan setting. We found that OALWH at the Kenyan coast are at risk of multiple physical, mental, and psychosocial challenges, likely affecting their HIV treatment and overall health. Before programmes can have any lasting impact on these adults, improved access to basic needs, including food, financial support, and caregiving, and a reduction of stigma and discrimination must be addressed. Future research should quantify the burden of these challenges and examine the resources available to these adults before piloting and testing feasible interventions.

Strategies for improving mental health and wellbeing used by adults ageing with HIV from the Kenyan coast: a qualitative exploration

“…The original study focused on understanding the health challenges and coping strategies of older adults living with HIV among 56 participants (34 OALWH, 11 caregivers and 11 healthcare providers). Arising from the primary dataset are two manuscripts; the first (a preprint published in medRxiv) reports the health challenges facing the OALWH 27 . Briefly, the participants’ narratives indicated that mental and psychosocial complaints, e.g., common mental health problems, poverty, stigma, and discrimination) were common among the OALWH in addition to physical health challenges, e.g., comorbidities and somatic symptoms).…”

Nature of Drug and Substance Abuse in Kilifi and Mombasa Counties of Coastal Kenya

“…The monetary burden of drug misuse in Kenya has been the subject of recent research. Drug misuse is related to significant healthcare expenses, according to research by Mwangala et al, (2022). These costs include hospitalization, medicine, and rehabilitation services.…”

Strategies for improving mental health and wellbeing used by adults ageing with HIV: a qualitative exploration

“…On the other hand, all the primary caregivers were family members, the majority (73%) of whom were female. Further sociodemographic information and HIV-related characteristics of the OALWH are described elsewhere 27 .…”

“…In 2019, we conducted a qualitative study on the coast of Kenya to understand the health challenges and coping strategies of older adults living with HIV among 56 participants (34 OALWH, 11 caregivers and 11 healthcare providers). Arising from this dataset are two manuscripts; the first one (a preprint published in medRxiv) reports the health challenges facing OALWH 27 . Briefly, the participants' narratives indicated that mental and psychosocial complaints, e.g.…”