Preface | p. xvii |
About the Authors | p. xxi |
HIV/AIDS in Middle-Aged and Older Adults: A Research Response | |
Incidence of HIV Disease Among Older Adults | p. 3 |
Importance of Studying the Impact of HIV on Older Adults | p. 7 |
Development of the West Central Florida Research Project | p. 10 |
Suggested Resources | p. 12 |
References | p. 12 |
Findings from the West Central Florida Survey of Middle-Aged and Older Adults with HIV Disease | |
Overview | p. 15 |
Background | p. 15 |
Survey Findings | p. 17 |
Demographic Characteristics | p. 18 |
HIV/AIDS Variables | p. 21 |
Medical Problems, Functioning Status, and Medications | p. 22 |
Difficulties Living with HIV/AIDS: Stressors, Coping, and Social Support | p. 23 |
Mental Health | p. 25 |
Historical Risk Events and Behaviors | p. 27 |
Conclusions | p. 28 |
References | p. 31 |
The Experience of Older Adults Living with HIV | |
Overview | p. 33 |
The HIV-Testing Experience | p. 41 |
Stigma | p. 48 |
Disclosing the HIV Diagnosis to Others | p. 50 |
Psychosocial Aspects of Living With HIV | p. 56 |
Significance of the HIV Diagnosis | p. 67 |
Life Changes Following HIV Diagnosis | p. 72 |
Life Assessment | p. 79 |
Conclusions | p. 81 |
Overview of the Biomedical Aspects of HIV and Its Impact on Older Adults | |
Overview | p. 83 |
Natural History of HIV Infection | p. 83 |
HIV Infection and Antibody Testing | p. 86 |
Prevention Aspects of HIV Disease Treatment | p. 88 |
Assessment of Nutritional Status and Dietary Counseling | p. 90 |
Historical Perspective of HIV Disease and Its Treatment | p. 91 |
Interactions of HIV Disease and Aging | p. 93 |
Conclusions | p. 103 |
Suggested Resources | p. 105 |
References | p. 106 |
HIV-Related Stressors, Coping, and Social Support | |
Overview | p. 113 |
A Review of Stress, Coping, and Social Support | p. 113 |
Stress, Coping, and Social Support Findings from the West Central Florida Project | p. 120 |
Conclusions | p. 124 |
Crisis Intervention | p. 127 |
Recommendations | p. 128 |
Suggested Resource | p. 130 |
References | p. 130 |
Mental Health and HIV | |
Overview | p. 133 |
Background | p. 133 |
Additional Mental Health Issues in Relationship to HIV Disease | p. 139 |
Mental Health Issues Among Older Adults with HIV Disease | p. 141 |
The West Central Florida Older Adult HIV/AIDS Project | p. 142 |
Treatment and Interventions for Mental Health Problems among PLWHIV or Persons at Risk for HIV Infection | p. 144 |
Conclusions | p. 148 |
Recommendations | p. 152 |
Suggested Resources | p. 153 |
References | p. 153 |
Providing Services to Older Adults with HIV Disease | |
Overview | p. 157 |
Challenges Presented in Caring for Older PLWHIV | p. 158 |
Case Management | p. 158 |
Models of Case Management | p. 160 |
Providing Health Care to Older PLWHIV | p. 166 |
Ambulatory Care | p. 166 |
Hospital Care | p. 166 |
Rural Health Care | p. 167 |
Providing Spiritual Care | p. 168 |
Enhancing Quality of Care | p. 169 |
Barriers to Accessing Health and Social Services | p. 170 |
Narrative Research Findings Related to the Service Experience of Older Adult PLWHIV | p. 171 |
Getting Information | p. 171 |
Accessing Services | p. 172 |
Evaluation of Service Experience | p. 175 |
Specific Concerns in Getting Needs Met | p. 177 |
Advice for Service Providers Dealing with Older PLWHIV | p. 182 |
The Perspective of Service Providers: Common Themes | p. 184 |
Observed Effects of Age | p. 190 |
Improving Services to Older PLWHIV | p. 192 |
Additional Resources | p. 193 |
References | p. 193 |
People of Color: HIV Prevention and Treatment Issues | |
Overview | p. 197 |
Ethnic Disparities Relating to HIV Disease | p. 198 |
African Americans | p. 200 |
Latinos/Hispanics in the United States | p. 211 |
Additional Considerations Regarding People of Color | p. 219 |
Conclusions | p. 222 |
Suggested Resources | p. 223 |
References | p. 224 |
Effects of HIV Disease on Women | |
Overview | p. 229 |
Counting Women among the HIV-Affected | p. 230 |
Gender and Disease Progression | p. 231 |
Medical Aspects of HIV in Women | p. 231 |
Social Management of HIV | p. 233 |
Psychosocial Issues Related to HIV Infection and Management | p. 234 |
Stigma, Blame, and Prejudice | p. 235 |
Sex, Drugs, and Money | p. 236 |
Domestic Violence | p. 237 |
Women Who Have Sex with Women | p. 237 |
Living with HIV/AIDS | p. 238 |
Prevention Programming for Women | p. 240 |
The Affected Women | p. 241 |
Conclusions | p. 242 |
Suggested Resources | p. 242 |
References | p. 242 |
Older Adult Sexuality and HIV | |
Overview | p. 247 |
Background | p. 247 |
What Seniors are Saying about Sex and Sexuality | p. 249 |
Sexual Concerns and Problems of Older Adults | p. 250 |
Sex and Sexuality in the Institutional Setting | p. 254 |
Importance of Sex Education | p. 255 |
Recommendations for Better Sex in Later Life | p. 256 |
Conducting a Sexual History | p. 258 |
Conclusions | p. 260 |
Suggested Resources | p. 263 |
References | p. 264 |
End of Life Issues | |
Overview | p. 265 |
Death as a Potential Growth Experience | p. 266 |
Theories about Death and Dying | p. 266 |
Philosophy of Life | p. 267 |
Resolution of Lingering Issues at the End of Life | p. 268 |
Exercising Control Over Death and Dying | p. 272 |
Support for the Terminally Ill | p. 274 |
Legal Issues | p. 277 |
Helping and Healing the Survivors | p. 279 |
Suggested Resources | p. 280 |
References | p. 281 |
HIV Prevention and Outreach | |
Overview | p. 285 |
Characteristics of HIV Risk among Older Adults | p. 286 |
Need for Prevention Education Targeting Older Adults | p. 287 |
Barriers to Effective Prevention Education | p. 289 |
Levels of Prevention | p. 290 |
Strategies for Effective Prevention Education Programs | p. 294 |
Developing Effective Messages | p. 295 |
Outreach | p. 297 |
Collaboration and Coalition Building | p. 299 |
Education for Care Providers | p. 300 |
Florida Initiatives | p. 301 |
Conclusions | p. 303 |
Suggested Resources | p. 304 |
References | p. 307 |
In Conclusion | |
Overview | p. 311 |
Here and Now | p. 31 |
Older Adults Living with HIV | p. 313 |
The Economics and Stressors of HIV/AIDS and Prejudice and Discrimination | p. 315 |
Overarching Mental Health Issues | p. 317 |
Ethnicity and Cultural Issues | p. 318 |
Service Issues | p. 320 |
Prevention and Advocacy | p. 321 |
Health Care Costs | p. 323 |
Recommendations | p. 323 |
Conclusions | p. 325 |
Middle-Aged and Older Adults with HIV Disease: West Central Florida Survey Project Description and Results | |
Background | p. 327 |
Methodology | p. 329 |
Results | p. 334 |
References | p. 358 |
Older Adult HIV/AIDS Interview Schedule | p. 359 |
Index | p. 381 |
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