Symptom Management with HIV Infected Older Persons

Nokes, Kathleen

Abstract

Older adults were more likely than younger people (13 percent and 6 percent respectively) to die within 1 month of their AIDS diagnosis (CDC, 1998).
The aim of this quasi-experimental randomized clinical study is to test the feasibility and refine a psychoeducational group intervention about managing physical and psychological symptoms which is designed for ambulatory older adults who are living with HIV/AIDS. It is hoped that participation in the 8 week psychoeducational group will increase knowledge about living with HIV/AIDS, use of healthy self-care behaviors, improved symptom status and improved physical functioning. The Momentum AIDS Project is a community based organization which provides meals and counseling services to more than 2000 people with HIV/AIDS in 11 sites throughout New York City. The sampling plan will be stratified and consists of two stages. The first stage will be to stratify the Momentum sites in terms of four regions: Manhattan below 60th St (3 sites), Manhattan above 60th St (3 sites), the Bronx (2 sites), and Other (3 sites). After the sites are put into appropriate strata, we will randomly select one intervention and one control site within each of the 4 stratum. The second stage of the sampling plan will be to select randomly 20 subjects within each of the 4 geographic stratums to be included in each cohort (10/experimental; l0/control). There will be a total of 4 cohorts since the 8 week psychoeducational group will be offered 4 different times. If there is a difference in physical functioning between the experimental and control groups, we would expect the distribution of the physical functioning scores (as measured by the SF-36 physical functioning subscale) to be different. The Kolmorgorov-Smirnov test for goodness of fit allows us to assess for possible differences. Data will be collected at baseline, immediately after the 8 week intervention, 2 and 6 months after the intervention. The desired outcome will be a refined psychoeducational group intervention which increases knowledge about HIV/AIDS and use of health self-care behaviors leading to improved symptom status and physical functioning of community living older persons with HIV AIDS.