The psychosocial needs of older people with HIV

Psychosocial health includes a person’s mental, emotional, social and spiritual wellbeing.

Mental health is an important part of overall psychosocial health.

Good mental health is essential to living and ageing well with HIV.

Many older people living with HIV experience excellent mental health. They are happy and well-connected. They feel positive about their futures.

But research shows many people living with HIV have negative feelings and thoughts about their HIV. Psychosocial support can transform these feelings and thoughts over time.


Video

Watch this video Across the ages ­on the experience of trauma, loss and grief; stigma and discrimination (00:00 – 8:20): https://www.youtube.com/watch?v=DyVPnaGsfQE


A national US study showed that:

  • Nearly 2 out of 3 people said it was difficult to tell people about their HIV status
  • 1 out of 3 people reported feeling guilty of ashamed of their HIV status
  • Nearly 1 in 4 people said their HIV status made them feel dirty or worthless.[1]

Older people living with HIV are more likely to report feeling isolated and lonely.

Almost 60% of older people living with HIV (50+) report symptoms of loneliness ranging from mild to severe.[2]

Loneliness is linked to smaller social support networks, depression, smoking and problematic alcohol and drug use.

Depression may impact as many as 40% of older people living with HIV. [3]

Depression is associated with experiences of stigma, loneliness, decreased cognitive functioning, reduced energy levels and accelerated ageing.[4]

Anxiety, insomnia and sleeplessness are also commonly reported by older people living with HIV.

For older people living with HIV poorer mental health is commonly associated with experiences of trauma, stigma and uncertainty.[5]

Trauma (linked to the past) may include grief and loss associated with the death of friends and loved ones, or rejection by family and peers.

Older people living with HIV may feel guilt about their HIV status and/or long-term survival when other peers have not survived.

Stigma(related to the present) may include older people’s experience of discrimination related to both HIV and age.

Older people living with HIV are also more likely experience other intersecting forms of stigma and discrimination. These may include homophobia, biphobia and transphobia; sexism; racism; ableism; and economic disadvantage.

Stigma can have a big impact on a person’s quality of life and self-image. It may lead to people:

  • avoiding healthcare or support services
  • not taking medicine and treatment
  • not disclosing their HIV status
  • living in denial about their HIV status
  • experiencing social isolation and loneliness.[6]

Fear and uncertainty(related to the future) may relate to many aspects of daily life. A person may be anxious about their ability to remain independent. They may be worried about being financially self-sufficient, or about their ability to stay in their home.

They may also be uncertain about their physical health or changes to memory and concentration. They may be anxious about continued access to support or confused about how to find the services they need.


Video

Watch this video on Understanding psychosocial support (3:54): https://www.youtube.com/watch?v=h8PHvxVmC0I


[1] Cited in Louis-Juste, Cynthia (2021). The connection between HIV and mental health in the older adult. Healthy Women.

[2] Kingsland, J (2020). Growing old with HIV: Challenges and opportunities.

[3] Ibid.

[4] Grov, C. et al. (2010). Loneliness and HIV-related stigma explain depression among older HIV-positive adults.

[5] Ibid.

[6] Louis-Juste, Cynthia (2021). The connection between HIV and mental health in the older adult. Healthy Women.

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