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Protective and risk factors associated with stigma in a population of older adults living with HIV in Ontario, Canada
- Authors:
- EMLET Charles A., et al
- Journal article citation:
- AIDS Care, 25(10), 2013, pp.1330-1339.
- Publisher:
- Taylor and Francis
Although the deleterious effects of HIV stigma are well documented, less is known about how various types of stigma impact older adults living with HIV disease and what factors exacerbate or lessen the effects of HIV stigma. Using cross-sectional data from the OHTN cohort study (OCS), we undertook multiple linear regression to determine the predictors of overall HIV stigma, and enacted, anticipated, and internalised stigma subscales in a sample of OCS participants age 50 and over (n=378). Being female, heterosexual, engaging in maladaptive coping, and having poor self-rated health were associated with greater overall stigma while being older, having greater mastery, increased emotional-informational social support, and a longer time since HIV diagnosis were associated with lower levels of stigma. The final model accounted for 31% of the variance in overall stigma. Differences in these findings by subscale and implications for practice are discussed. (Publisher abstract)
Knowledge and use of AIDS and aging services by older, HIV-infected adults
- Author:
- EMLET Charles A.
- Journal article citation:
- Journal of HIV/AIDS and Social Services, 3(1), 2004, pp.9-24.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This American study of 41 adults, age 50 and over with HIV/AIDS, compared the knowledge and use of services commonly available from the HIV network as well as the ageing network. The study sample had similar knowledge of HIV services and services designed for older adults. These individuals, however, used a significantly higher number of services provided through the HIV network (mean of 2.61 services) compared to the aging network (mean of .68 services). Predictors for service use varied across systems. While the primary predictor of HIV service use was awareness, Medicaid eligibility and living arrangements were predictive of use of services from the aging network.
The graying of HIV/AIDS: preparedness and needs of the aging network in a changing epidemic
- Authors:
- EMLET Charles A., GERKIN Amanda, OREL Nancy
- Journal article citation:
- Journal of Gerontological Social Work, 52(8), November 2009, pp.803-814.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The number of older adults (aged 50 years and over) living with HIV/AIDS has increased consistently during the last decade, and between 2001 and 2007 the estimated number of older people living with HIV/AIDS in the US increased from 65,445 to 156,511. This study examined the extent to which 13 Area Agencies on Aging (AAAs) in Washington State are prepared and have the required experience and skills to serve older adults with a diagnosis of HIV/AIDS, using a survey of staff at AAAs, and looked at the potential impact further implementation of Aging and Disability Resource Centers (designed to enhance access to community living, to deliver person centred information to individuals needing services, and to serve as an entry point for streamlined access to public or private resources) might have on service delivery. The majority of respondents agreed that serving HIV positive older adults was consistent with their mission but few indicated that they had substantial experience with this population. The authors make recommendations for improving service delivery, and conclude that the results of this pilot study support the feasibility of an expanded study.
‘I'm happy in my life now, I'm a positive person’: approaches to successful ageing in older adults living with HIV in Ontario, Canada
- Authors:
- EMLET Charles A., et al
- Journal article citation:
- Ageing and Society, 37(10), 2017, pp.2128-2151.
- Publisher:
- Cambridge University Press
Worldwide approximately 3.6 million people aged 50 and older are living and ageing with the human immunodeficiency virus (HIV). Few studies have explored successful ageing from the insider perspective of those living well and ageing with HIV. This study draws upon the lived experience and wisdom of older, HIV-positive adults living in Ontario, Canada in order to understand their views and strategies for successful ageing. This qualitative study involved semi-structured interviews with 30 individuals age 50 years and older who are HIV-positive. Purposive sampling techniques were used to recruit individuals who shared their experiences of successful ageing. Constructivist grounded theory coding techniques were used for analysis. Themes related to successful ageing included resilience strategies and challenges, social support and environmental context. Stigma and struggles to maintain health were identified as impediments to successful ageing. Models of successful ageing must take into account the potential for a subjective appraisal of success in populations suffering from chronic and life-threatening illnesses including HIV. Practitioners can draw upon organically existent strengths in this population in order to provide intervention development for older adults around the world who are struggling to manage their HIV. (Publisher abstract)
Using a standardized patient approach to enhance clinical skills in gerontological social work
- Author:
- EMLET Charles A.
- Journal article citation:
- Journal of Social Work Education, 46(3), 2010, pp.443-451.
- Publisher:
- Council on Social Work Education
An increase in the number of older adults in the US, together with new accreditation standards based on competencies, requires social workers to show competence in working with older clients. This teaching note reports on the development and use of a standardised patient role-play to teach and evaluate the ability of graduate social work students to conduct an appropriate and sensitive mental status examination. It describes the use of a scenario-based role-play for an assignment on a graduate level course for Master of Social Work students in their 2nd or 3rd year of study on a Gerontological Social Work: Health and Mental Health in Older Adults course. The logistics of the exercise and methods used for evaluating student performance are discussed. A chart is included showing standards, clinical components, evaluation criteria, and scoring for standardised patient evaluation.
HIV/AIDS treatment
- Authors:
- EMLET Charles A., SHIPPY R. Andrew
- Journal article citation:
- Journal of Gerontological Social Work, 50(S1), 2008, pp.131-149.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Although the number of people being diagnosed with HIV AIDS continues to decline in the USA, the numbers living with the condition rise. Older people are likely to comprise an increasing proportion of the HIV AIDS population, and include two sub-groups: those infected in later life; and those ageing with HIV disease. The major psychosocial challenges posed by HIV AIDS (stigma, support, coping) may be exacerbated by the effects of ageing, including a natural decline in immune system responsiveness and the presence of co-morbid conditions. This paper reviews empirical evidence on psychosocial interventions with HIV AIDS patients aged 50 or over. Only three studies met the inclusion criteria, indicating the embryonic nature of research in this area, but all three provided some positive results. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Extending the use of the 40-item HIV-stigma scale to older adults: an examination of reliability and validity
- Author:
- EMLET Charles A.
- Journal article citation:
- Journal of HIV/AIDS and Social Services, 6(3), 2007, pp.43-54.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The original testing of the 40-item stigma scale developed by Berger et al. included very few older people but the need for appropriate measurement instruments has been heightened by the survival of people with HIV/AIDS to older ages, and also by new infections in people over 50. The scale was administered to 25 older adults (mean age 56.1 years) who also completed a semi-structured questionnaire about their views on how well the scale captured their experience of stigma. The scale, and its four sub-scales, showed excellent internal consistency and good convergent validity with the CES-D depression scale. Sixty-four respondents felt that it did a good job in capturing their experiences of stigma, or offered suggestions for improvement. The author concludes that the scale appears to maintain its integrity when used with older people. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
"You're awfully old to have this disease": experiences of stigma and ageism in adults 50 years and older living with HIV/AIDS
- Author:
- EMLET Charles A.
- Journal article citation:
- Gerontologist, 46(6), December 2006, pp.781-790.
- Publisher:
- Oxford University Press
Older adults living with HIV infection may be doubly stigmatized, as they are branded by both age as well as HIV status. Through semi structured interviews, this study sought to examine whether older adults with HIV/AIDS experience both ageism and HIV stigma and how those experiences manifest in their lives. Twenty-five in-depth interviews were completed with adults aged 50 years and older who were living with HIV or AIDS in the United States. Purposive sampling was used to recruit these individuals who shared their experiences. Open coding and axial coding of interview transcripts were completed on all interviews, resulting in the development of a framework of these experiences. The majority (68%) of the respondents experienced both ageism and HIV-associated stigma. The experiences were often separate, although some interrelated stigma did occur. Nine themes emerged from the interviews, including rejection, stereotyping, fear of contagion, violations of confidentiality, and internalized ageism. All themes fell into four categories: social discrimination, institutional discrimination, anticipatory stigma, and other. The research identified themes that may be sources of felt as well as enacted stigma and discrimination related to both aging and HIV. This concept of double jeopardy exists in the lives of the majority of people interviewed and has relevance to the creation of appropriate intervention strategies.
HIV/AIDS and older adults in North America
- Authors:
- EMLET Charles A., ZABLOTSKY Diane
- Journal article citation:
- Global Ageing, 4(2), August 2006, pp.72-85.
This article discusses how the profile of how HIV/AIDS impacts older adults who are infected or at-risk for HIV across the United States and Canada. The article first provides epidemiological trends for both countries, including patterns related to gender, ethnicity and transmission routes. It then goes on to discuss psychosocial issues faced by older adults living with HIV/AIDS, including issues of stigma and social support. The article concludes with an examination of service delivery and access to services in the US and Canada.
A feminist approach to practice in working With midlife and older women with HIV/AIDS
- Authors:
- EMLET Charles A., TANGENBERG Katy, SIVERSON Claire
- Journal article citation:
- Affilia: Journal of Women and Social Work, 17(2), Summer 2002, pp.167-190.
- Publisher:
- Sage
Older women with HIV/AIDS constitute an invisible population that is often ignored by organisers of HIV prevention efforts as well as by HIV and aging organisations. This article explores the importance of a feminist approach to practice with a population affected by the intersection of ageism, sexism, and AIDS phobia. Describes a support group for midlife and older women with HIV/AIDS is, and discusses four themes that were identified by the group participants.