Solomon P.1, Letts L.1, O'Brien K.K.2, Nixon S.2, Baxter L.3, Gervais N.1
1McMaster University, School of Rehabilitation Sciences, Hamilton, Canada, 2University of Toronto, Physical Therapy, Toronto, Canada, 3Volunteer, Halifax, Canada
Background: As people living with HIV (PLWH) continue to live longer, successful aging in the context of HIV has become an important consideration. Successful aging is a particular concern given the earlier onset of numerous comorbidities and cognitive challenges, in conjunction with the stigma and discrimination often experienced by PLWH. It is important for physiotherapists to understand significant contributors to successful aging to develop interventions that best meet the needs of PLWH.
Purpose: The purpose of this qualitative study was to understand how PLWH define successful aging and their perceptions of contributors to successful aging.
Methods: This was a component of a larger longitudinal study examining the nature of episodic disability in PLWH as they age. We recruited participants recruited from AIDS Service Organizations in Southern Ontario, Canada to participate in a series of four face to face interviews over 1.5 years. Eligibility criteria included: age 50 years or older; HIV diagnosis longer than 6 years; and ability to read and understand English. Interviews were designed to explore men and womens experiences of aging with HIV over time through a disability and rehabilitation lens. At the completion of the fourth interview, we asked participants to provide their thoughts of how they would define successful aging and to reflect on their perceptions of whether they considered themselves to be aging successfully. We analyzed the transcribed audio-recordings of the interviews using open coding and a directed content analysis to identify elements of successful aging. After the initial coding, we compared codes and grouped these into these into broader themes. This study received approval from the Research Ethic Boards at McMaster University and the University of Toronto.
Results: We recruited 24 participants (14 men and 10 women) with a mean age was 57 years (range 50 to 73 years) and mean time since diagnosis was 18 years (range 6 to 30 years). We identified six themes related to the participants perspectives regarding successful aging: accepting limitations, staying positive, maintaining social supports, taking responsibility, living a healthy lifestyle and engaging in meaningful activities.
Conclusion(s): Participants focussed on elements of successful aging that emphasized individual control highlighting the important role physiotherapists have in developing self-management programs with PLWH. The need for ongoing social support suggests that physiotherapists also have a role in linking PLWH to community resources. The importance of understanding successful aging from an individuals perspective is important to assist in goal setting and ensure that the client is engaging in meaningful activities.
Implications: From a clinical perspective this highlights the importance of working with PLWH to understand their values and aspirations as they age, and create patient centered goals that are meaningful to the individual. From a research perspective this reinforces calls to include the subjective experiences of older adults in developing successful aging criteria.
Funding acknowledgements: Work supported under CIHR - Grant HHP 131556. K.K. O'Brien and S. A. Nixon supported by CIHR New Investigator Award.
Topic: Oncology, HIV & palliative care
Ethics approval: Ethics approval was provided by Hamilton Integrated Research Ethics Board and University of Toronto Research Ethics Board
All authors, affiliations and abstracts have been published as submitted.
