Understanding of the risk of HIV infection among the elderly in Ga-Rankuwa, South Africa

Lekalakala-Mokgele, Eucebious

doi:10.1080/17290376.2014.931816

Cited by 16 publications

(13 citation statements)

References 46 publications

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“…Next, we argue that as the HIV epidemic ages, the standard categories and trajectories of risk highlighted in HIV research and policy need to be rethought [ 13 , 46 ]. Older persons, and particularly older women, could be sexually inactive but infected many years prior.…”

Section: Discussionmentioning

confidence: 99%

“I was referred from the other side”: Gender and HIV testing among older South Africans living with HIV

Schatz

Knight

2018

PLoS ONE

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South Africa has a Universal Test and Treat (UTT) policy in place to ensure that everyone tests for HIV and can access treatment if they test positive. The aim of this study is to document the pathways that older South Africans who are living with HIV take to access testing and treatment in this context. Despite the aging of the HIV epidemic in South Africa and clear evidence that testing older persons (over age 50) is necessary, very little is known about the circumstances under which older persons test for HIV or their motivations for doing so. In this study, we analyze 21 qualitative, in-depth interviews with women and men aged 50 and over who are living with HIV from two townships outside of Cape Town. Using grounded theory to specify emerging themes, we find similarities and differences between older men and women in their pathways to testing. Men primarily test for HIV when their spouse is diagnosed or in connection with TB testing and treatment. Older women, who are more likely to be widowed or divorced, often test for HIV only when they are symptomatic or not responding appropriately to care for non-communicable diseases. Most importantly, we find that older South Africans do not seek testing as a response to risk. Instead, older men and women test only once they are symptomatic and referred by a provider, or as a result of a partner’s status. Our respondents, particularly the women, expressed “shock” and confusion at learning they were HIV-positive because they do not see themselves as at risk of acquiring HIV. Because the benefits of UTT are greatest with early detection and treatment, older persons’ tendency to test at such a late stage of illness decreases the individual and population level advantages of UTT. More research is needed to understand older persons’ risk and testing behavior so that policy and programs include HIV testing messages that reach this population.

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Section: Discussionmentioning

confidence: 99%

“I was referred from the other side”: Gender and HIV testing among older South Africans living with HIV

Schatz

Knight

2018

PLoS ONE

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“…Providing sensitive support for some of these groups might be one approach to promoting HIV control amongst older adults. In addition, efforts are needed to ensure that testing and treatment services are responsive to the needs of older adults to encourage higher rates of service coverage [7,34]. …”

Section: Discussionmentioning

confidence: 99%

Rising Levels of HIV Infection in Older Adults in Eastern Zimbabwe

et al. 2016

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BackgroundWith the scale-up of antiretroviral treatment across Africa, many people are living longer with HIV. Understanding the ageing of the HIV cohort and sexual behaviour among older adults are important for appropriately responding to the changing demographics of people living with HIV.MethodsWe used data from a large population-based open cohort in eastern Zimbabwe to examine HIV prevalence trends and incidence among those aged 45 years and older. Five survey rounds have been completed between 1998 and 2011. Incidence was analysed using midpoint between last negative and first positive HIV test.ResultsAcross the survey rounds, 13,071 individuals were followed for 57,676 person years. While HIV prevalence among people aged 15–44 has fallen across the five rounds, HIV prevalence among those aged 45–54 has increased since the 2006–08 survey round. In the 2009–11 round, HIV prevalence among men aged 45–54 was 23.4% compared to 11.0% among those aged 15–44. HIV positive people aged 45–54 now represent more than 20% of all those living with HIV in Manicaland. Among those aged 45 years and older, there were 85 seroconversions in 11,999 person years for an HIV incidence of 0.708 per 100 person years. Analysis of cohort data and assessment of behavioural risk factors for HIV infection among older people shows significantly lower levels of condom use among older adults and a number of seroconversions past the age of 50.ConclusionsThe cohort of people living with HIV is ageing in Zimbabwe and the behaviour of older adults puts them at risk of HIV infection. Older adults must be included in both HIV prevention and treatment programs.

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“…Those who have been diagnosed with HIV and are adhering to treatment are now living longer, healthier lives. Thus, negative feelings about treatment, infectiousness, and stigma may be becoming less impactful on HIV testing (Lekalakala-Mokgele, 2014;Prati et al, 2015). Still, our evidence suggests that these beliefs directly feed into information avoidance tendencies, which then impact testing behavior.…”

Section: Implications and Applicationsmentioning

confidence: 78%

Psychological threat avoidance as a barrier to HIV testing in gay/bisexual men

et al. 2019

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The present study examined how three psychosocial barriers-anticipated HIV stigma, HIV infectiousness-reduction beliefs, and optimism about available HIV treatments-related to HIV testing history and acceptance of an at-home HIV test among men who have sex with men. We also examined the mediating role of a variable that affects medical screening for other health conditions but has not yet been investigated in HIV contexts: the tendency to avoid psychologically threatening information. Volunteers completed a paper and pencil survey and were offered a free at-home HIV test during the 2015 Atlanta Pride Festival in Atlanta, GA. Anticipated HIV stigma, infectiousness beliefs, and treatment optimism were inconsistently related to HIV testing history and acceptance of an at-home HIV test, but all had direct effects on the desire to avoid HIV information. In a mediation model, each of these psychosocial barriers had indirect effects on both HIV testing outcomes via information avoidance. These findings suggest that information avoidance is an important proximal HIV testing barrier, thus providing a novel target for interventions and information campaigns. Keywords HIV testing Á Decision making Á Psychosocial barriers Á Medical testing Á MSM Despite advances in HIV treatment and testing technologies, new infections currently outpace prevention efforts. In 2015, the Centers for Disease Control and Prevention (CDC) reported 39,513 new HIV infections in the United States (Centers for Disease Control and Prevention, 2015b). The geographic epicenter of HIV diagnoses has shifted geographically since early diagnoses (e.g., 1981), from the northeast and west coast to the southern United States (Centers for Disease Control and Prevention, 2016a). Atlanta, Georgia, for example, ranked first among cities for number of new HIV infections in 2015 (Centers for Disease Control and Prevention, 2015a). Men who have sex with men (MSM) remain the predominant group affected by HIV infection, accounting for approximately two-thirds of all new HIV infections each year (Centers for Disease Control and Prevention, 2016b). As the diagnostic gateway to care, the CDC has focused on HIV testing, recommending that sexually active MSM get tested every 4-6 months (Centers for Disease Control and Prevention, 2014a). Despite intensive efforts to increase testing ratesincluding no longer requiring time-consuming risk reduction counseling, and the availability of rapid testing-an

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Understanding of the risk of HIV infection among the elderly in Ga-Rankuwa, South Africa

Cited by 16 publications

References 46 publications

“I was referred from the other side”: Gender and HIV testing among older South Africans living with HIV

“I was referred from the other side”: Gender and HIV testing among older South Africans living with HIV

Rising Levels of HIV Infection in Older Adults in Eastern Zimbabwe

Psychological threat avoidance as a barrier to HIV testing in gay/bisexual men

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