Strategies for improving mental health and wellbeing used by older people living with HIV: a qualitative investigation

Abstract

Recent research into "successful ageing" and "resilience" in the context of ageing with HIV highlights older people living with HIV's (OPLWH) adaptations and coping strategies hitherto neglected by early research's emphasis on difficulties and challenges. Yet "resilience" and "successful ageing" are limited by their inconsistent definition, conflation of personal traits and coping strategies, normative dimension, and inattention to cultural variation and the distinctive nature of older age. This article thus adopts an interpretivist approach to how OPLWH manage the challenges to their mental health and wellbeing of ageing with HIV. Drawing on interviews with 76 OPLWH (aged 50+) living in the United Kingdom, we document both the strategies these participants use (for example, "accentuating the positive" and accessing external support) and the challenges to these strategies' success posed by the need to manage their HIV's social and clinical dimensions and prevent their HIV from dominating their lives. This points to (a) the complex overlaps between challenges to and strategies for improving or maintaining mental health and wellbeing in the context of ageing with HIV, and (b) the limitations of the "resilience" and "successful ageing" approaches to ageing with HIV.

Longitudinal trajectories of emotional problems and unmet mental health needs among people newly diagnosed with HIV in China

“…Mental health morbidity affecting people living with HIV is becoming an increasing concern worldwide with depression and anxiety most prevalent . At the end of September 2018 there were 849,602 people living with HIV in China of whom 41.5% were AIDS patients .…”

Lesbian, Gay, Bisexual, and Trans Aging in a U.K. Context: Critical Observations of Recent Research Literature

“…UK research into the lives of older LGBT people have paid attention to a number of issues alongside generic health and social care needs facing our oldest generations. These include growing old with HIV/AIDs (Nagington, 2015;Rosenfeld, Catalan, & Ridge, 2018), dementia and end of life care (Almack, 2018;Bristowe, Hodson, Wee, Almack, Johnson, Daveson, &Harding, 2018).…”

“…In England, gay men remain the predominant social group who are affected by HIV (Nagington, 2015). Rosenfeld, Catalan, & Ridge (2018) identify how strategies of 'successful ageing can be problematic and often measured by heteronormative standards. Rosenfeld et al, (2018) also identify strategies that help men prevent their HIV from dominating their lives and to manage the challenges to their mental health and wellbeing of ageing with HIV.…”

“…Rosenfeld, Catalan, & Ridge (2018) identify how strategies of 'successful ageing can be problematic and often measured by heteronormative standards. Rosenfeld et al, (2018) also identify strategies that help men prevent their HIV from dominating their lives and to manage the challenges to their mental health and wellbeing of ageing with HIV. Nagington (2015) argues a need for more culturally appropriate solutions to sit alongside pharmaceutical solutions, to successfully address the social difficulties experienced by gay men to prevent their HIV from dominating their lives.…”

‘The own’ and ‘the wise’ as social support for older people living with HIV in the United Kingdom

“…I think to actually be able to empathise properly, you need to be in the same boat. It's very easy to say ‘Well, you know, it must be difficult to live with it’ or ‘It must be easy to live with it’; if you aren't in that situation, then it's not so easy.As we show below, MSM had readier access to other PLWH than did the heterosexuals in the sample, but for many MSM, and all heterosexual participants, the most usual means of finding non-romantic support from ‘the own’ were HIV-dedicated websites (some of which were dating sites) and HIV organisations and groups, which 55 per cent of participants attended at the time of interview, with most of these attending no other kind of group (those who did not attend these groups cited being sufficiently informed and/or seeking to avoid having their HIV ‘define’ or ‘dominate’ their lives; see Rosenfeld et al ., 2018). Of these 55 participants, most were Black African (80% versus 44% of White participants), female (74% versus 48% of male participants) and heterosexual (74% versus 32% of MSM).…”