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Assessing the needs of older HIV+ adults; Initial data from the CORE Healthy Aging Initiative (CHAI) - Money, Mental Health, Housing Top List of Concerns in Older HIV+ Chicago Group
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IDWeek 2016, October 26-30, 2016, New Orleans
"Many aging HIV+ patients live alone, and the interplay of co-morbidities, poly-pharmacy, memory issues, and falls places them at an increased risk for non-independent living at an earlier age than the general population......median age stood at 56 years.....40% reported mental health is a concern...42% reported a history of depression.....One third reported memory problems or concerns, and 27% reported one or more falls in the past 12 months.....46%, lived alone.....54% took four or more prescription medicines daily"
Mark Mascolini
Older Chicago residents with HIV listed money as often as HIV among their top five concerns, according to results of a 389-person survey [1]. Housing and mental health ranked third and fourth on the list. More than half of survey respondents took four or more prescription medications daily, and more than 40% reported smoking, high blood pressure, or depression.
To get a better understanding of the needs and concerns of aging people with HIV in an inner-city Chicago cohort, researchers at the RME CORE Center administered a 63-question written survey in English or Spanish to center clients from March through May 2016. Everyone who completed the survey was 50 or older, and median age stood at 56 years. Almost three quarter of respondents were black, 15% Hispanic, 10% white, and 17% women. Three quarters had an HIV diagnosis for more than 10 years and 41% for more than 20 years. Almost everyone, 97%, was taking antiretroviral therapy.
While 44% of respondents smoked, 71% of smokers said they wanted to quit now. The same proportion, 44%, reported having high blood pressure, 42% reported a history of depression, 25% considered themselves overweight, and 24% had high lipids. More than half of respondents, 54%, took four or more prescription medicines daily, and 45% took vitamins, supplements, or other nonprescription agents. Yet 44% of respondents listed their health as excellent or very good, 47% as fair, and only 10% as poor or very poor.
Almost half of the study group, 46%, lived alone, and 81% called themselves their primary caregiver. One third reported memory problems or concerns, and 27% reported one or more falls in the past 12 months, of whom 55% told someone of their fall only sometimes or never.
Almost two thirds of respondents, 61%, listed either HIV or money as one of five top concerns. Other frequent concerns were housing (41%), mental health (40%), HIV disclosure/stigma (35%), caregiver in old age (35%), and other medical concerns (35%).
High proportions of respondents had a cell phone (83%) or a house phone (22%), 62% used text messaging, 56% used facebook, 45% used other social media, and about half used social media daily.
Caucasians and Hispanics were significantly more likely than blacks to have their own residence (P = 0.000), though English speakers were more likely to live alone than Spanish speakers (48% versus 28%, P = 0.021). Caucasians and blacks were more likely than Hispanics to report falling (P = 0.000), and English speakers were more likely than Spanish speakers to smoke (48% versus 5%, P < 0.000) and to have HCV infection (26% versus 8%, P = 0.013).
The CORE team noted that many older HIV-positive people live alone and that concomitant comorbidities, polypharmacy, memory problems, and falls "place them at an increased risk for nonindependent living at an earlier age than the general population." The researchers suggested that health workers can use text messaging and social media to promote healthy living in older people with HIV.
Reference
1. Adeyemi O, Catrambone J, Rebolledo W, Burke K, Bahk M, Carmack A. Assessing the needs of older HIV+ adults: initial data from the CORE Healthy Aging Initiative (CHAI). IDWeek 2016, October 26-30, 2016, New Orleans. Abstract 2126.
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Assessing the needs of older HIV+ adults; Initial data from the CORE Healthy Aging Initiative (CHAI)
O. Adeyemi, MD1,2,3, J. Catrambone, MA1, W. Rebolledo, BA1, K. Burke, MPH1, M. Bahk, BA, BS1, and A. Carmack, MPH1
Ruth M. Rothstein(RMR)CORE Center1, Cook County Health and Hospitals System2, Rush University Medical Center3
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