As antiretroviral and prophylactic treatments for HIV and associated diseases become increasingly effective in impeding disease progression, growing numbers of individuals will live with HIV infection as a chronic illness for lengthening periods of time. Hence, to understand how these individuals manage the many adaptive tasks associated with their seropositive status and to assess the quality of life they achieve is important for the provision of their care. The Principal Investigator proposes to examine the psychosocial adaption to living with HIV infection among late middle-age and elderly (50+ years) adults from the greater New York City metropolitan area--an epicenter of the epidemic for older adults. These older HIV-infected individuals represent a very understudied segment of the population impacted by the AIDS epidemic. The research focus will be on identifying similarities and differences in adaptive tasks posed by the illness, coping responses evoked, and adaptational outcomes among infected individuals from three race/ethnic groups: native-born, non-Hispanic-whites, native-born African-Americans, and Puerto Ricans. A total of 60 infected older adults, 20 from each race/ethnic group, will be studied; within each race/ethnic group, 13 cases will be men and seven women. Given the dearth of information about the psychosocial adaption of older HIV-infected adults, a qualitative research design is proposed.
The specific aims are: (1) to identify and describe the varied adaptive tasks that older HIV-infected adults must accomplish to successfully adjust to their condition and how these may or may not vary by race/ethnicity, by gender, by disease stage (AIDS vs. HIV-positive); (2) to identify and describe the coping strategies used by older HIV-infected adults to address the varied adaptive challenges posed by their condition and how these may or may not vary by race/ethnicity, by gender, by disease stage; (3) to examine, for each adaptive task, the consequences (i.e., both adaptive and maladaptive) of alternative coping responses and how these may or may not vary by race/ethnicity, by gender, and by disease stage; (4) to examine older, HIV-infected adults' perceptions of the adequacy of available informal and formal support, and their perceptions of factors that impede or facilitate access to needed support resources; and (5) to gather information that will inform the design of a subsequent survey study of the research issues (e.g., information regarding appropriate criteria for successful adaptation, data on the suitability of existing standardized measures for investigating coping and adaption among older HIV-infected adults).
