Hiv infection in older adults

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AIDS Care. Author manuscript; available in PMC 2011 April 19.
Published in final edited form as: AIDS Care. 2010 ; 22(5): 630–639. doi:10.1080/09540120903280901.

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Loneliness and HIV-related stigma explain depression among older HIV-positive adults
Christian Grov, PhD, MPH1,2,Sarit A. Golub, PhD, MPH2,3,4, Jeffrey T. Parsons, PhD.2,3,4, Mark Brennan, PhD5, and Stephen E. Karpiak, PhD5 1 Department of Health & Nutrition Sciences, Brooklyn College of the City University of New York
2 3

Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY

Department of Social & Personality Psychology, The Graduate Center of the City University of New York, NY
45

Department of Psychology, Hunter College of the City University of New York, NY AIDS Community Research Initiative of America (ACRIA), New York, NY

Abstract
Advances in the treatment of HIV have resulted in a large growing population of older adults with HIV. These aging adults face added social, psychological, and physical challenges associated with the aging process. Correlationsbetween depression, loneliness, health, and HIV/AIDS-related stigma have been studied, but there is little evaluation of these associations among HIV-positive adults over the age of 50. Data for these analyses were taken from the Research on Older Adults with HIV (ROAH) study of 914 New York City-based HIV-positive men and women over the age of 50. In total, 39.1% of participants exhibited symptoms ofmajor depression (CES-D ≥ 23). Multivariate modeling successfully explained 42% of the variance in depression which was significantly related to increased HIV-associated stigma, increased loneliness, decreased cognitive functioning, reduced levels of energy, and being younger. These data underscore the need for service providers and researchers to assert more aggressive and innovative efforts toresolve both psychosocial and physical health issues that characterize the graying of the AIDS epidemic in the United States. Data suggest that focusing efforts to reduce HIV-related stigma and loneliness may have lasting effects in reducing major depressive symptoms and improving perceived health.

INTRODUCTION
The number of people aged 50 and older living with HIV in the U.S. increased 77%between 2001–2005, accounting for 25% of all HIV cases and 29% of all persons living with AIDS in the U.S. (CDC, 2008a; Martin, Fain, & Klotz, 2008). This has been described as the “graying” of the HIV/AIDS epidemic (Gorman, 2006; Shah & Mildvan, 2006). In 2006, almost 38% of HIV-positive persons were between the ages of 40–49. As these individuals receive treatment allowing them to live longer, thenumbers of HIV-positive persons over 50 will increase by 67% in the next decade (CDC, 2008b). This growth is paralleled by small increases in newly diagnosed HIV infections in the over 50 population; in 2007, 15% of new diagnoses occurred among adults 50 and older (CDC, 2008b).

Corresponding author: Christian Grov, PhD, MPH, Assistant Professor, Department of Health and Nutrition Sciences,Brooklyn College – CUNY. 2900 Bedford Avenue, Brooklyn, NY. 11210. (718) 951-5000 × 1230, cgrov@brooklyn.cuny.edu.

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Older HIV-positive adults confront both the process of aging and managing their HIV/AIDS (Bhavan, Kampalath, & Overton, 2008; Emlet, 2006, 2004; Magalhaes, Greenberg, Hansen, & Glick, 2007; Vance, Farr, & Struzick, 2008). In older adults with HIV, as in theiryounger counterparts, high levels of psychological distress are common. Rabkin (2008) reported that depression was the second most prevalent behavioral health issues among HIV-positive adults, and Bing et al. (2001) estimated the prevalence of depression among HIV-positive adults at 36%. While a wide range of depression rates in HIV-positive adults have been reported (1–48%), Rabkin (2008)...