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HIV Stigma / Women /Aging / Relationships / Isolation
/ Depression-Mental Health / CVD
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Should Mental Health De Addressed in Older HIV+ better than it is now ?? Certainly European advocates think so because they just launched a project to do this and presented it this week at the European Parliament !!!!!


As people with HIV Age these problems often get worse - stigma, isolation, loneliness / no relationship, depression - Do aging HIV+ deserve attention & recognition to address these problems? Certainly these issues can and will for some reduce survival and increase morbidity and sicknesses. Services for AGING HIV+ should be addressing this !We need better ACTG & NIH research & support services from CDC, RWCA, HRSA. Jules
Stigma in HIV: 53% Report Social Stigma & 60% Report Self-Stigma.....high levels of depression, anxiety particularly for >50 Years Old - 63% Report 3 or more Comorbidities - (11/20/17)
Love with HIV: a latent class analysis of intimate relationships among women living with HIV enrolled in Canada's largest multisite community-based research study...."Nearly half of Canadian WLWH were not in relationships"
- 20% report long-term happy relationships .....Take a look at Table 2 where you will see depression & stigma are present in around 50% of all women; viral load undetectable in about 80%. How many people tell me - oh HIV is under control today, its not a problem, tell this to HIV men & women who are unable to form relationships & suffer with the stigma & depression associated with having HIV !....27% Depressed / 20% Detectable Viral Load / 40% High Stigma / 16% Illicit Drug Use
- 47% no relationship
- 9% relationship without love
- short-term casual 16%
- long-term unhappy 7%
- long term happy 22%
We delineated 5 latent classes:
no relationship (47%), relationship without sex (9%), and three types of sexual
relationships-short-term/casual (16%), long-term/unhappy (7%), and long-term/happy (22%).

major depressive disorder associated withincreasedheart attack risk [acute myocardial
infarction] by 30% in HIV+
Association Between Depressive Disorders and Incident Acute Myocardial Infarction in Human Immunodeficiency Virus-Infected AdultsVeterans Aging Cohort Study - depression & mortality in HIV - (09/07/16)
Childhood Trauma and Health Outcomes in HIV-Infected Patients: An Exploration of Causal Pathways- (03/23/12)
"greater lifetime trauma exposure was associated with all outcomes considered (Table 3). Each additional type of lifetime trauma was associated with 18% increased odds of unprotected sex, 13% (3% to 24%) increased odds of ARV nonadherence, 12% (4% to 21%) increased odds of hospitalization, 14% (6% to 22%) increased odds of ED use, 13% (5% to 22%) increased odds of more than 4 days in bed, a 12% (0% to 24%) increased hazard of HIV disease progression, and a 0.8-unit (0.4-1.2) lower SF36 physical health score."
The Pervasive Effects of Childhood Sexual Abuse: Challenges for Improving HIV Prevention and Treatment Interventions EDITOIRAL-- (03/23/12)
Associations of Sexual Identity or Same-Sex Behaviors With History of Childhood Sexual Abuse and HIV/STI Risk in the United States-- (03/23/12)
Study of the Day: 1 in 4 Adults With HIV Were Sexually Abused as Kids-- (03/23/12)
Depression Tied to Worse Cognitive Function in MACS Men With or Without HIV.....http://www.natap.org/2015/AGE/AGE_13.htm
Aging & HIV - an unaddressed timebomb waiting to explode - slide presentation by Jules Levin, NATAP-- (03/14/17)
HIV & Aging - Mental Needs: Policy, Mental Health Services Program, Comorbidities, Services for Aging/Older HIV+-
- inability to function:loss of income/housing, depression, increased substance abuse, emotional instability, suicide, non-adherence
- increased comorbidities vs HIV-neg but less coping capacities
-The more medical comorbidities someone experiences, the poorer their quality of life
-Integration of HIV primary care and mental health
-healthcare providers, front-line workers, and policy makers should have a greater understanding of the experience of aging with HIV......policy makers......HAND can have damaging effects on older adults' psychosocial well being
- ......many research gaps need to be addressed,
including a better conceptualization and measurement of successful aging and thedevelopment of high-quality integrated care, programs, and servicestailored to the needs of older people with HIV. A moreintegrated policy response is needed to improve the psychosocial and economicwell being ofolder people with HIV. The process of aging may be more challenging for people living with HIV than for the general population. This is because of the detrimental effects that HIV and its treatment have on normal aging processes as well as other factors, such as HIV-related stigma, loss of friends and social networks..... http://www.natap.org/2014/HIV/092914_02.htm

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