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Title: HIV/AIDS in older adults : a biopsychosocial perspective in the era of effective ART
Author: McGowan, J. A. L.
ISNI:       0000 0004 7660 1208
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2016
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The average age of the HIV population is increasing, due primarily to advances in antiretroviral treatment. Adults over the age of 50 will soon make up the majority of adults with HIV in resource rich settings. However, research into their well-being is lagging behind. An initial systematic review into the well-being of older persons with HIV (PWH), conducted as part of this thesis, revealed little comprehensive research. Even fewer studies were identified exploring the effects of 'time diagnosed with HIV' on well-being, which is increasingly a significant variable in HIV care. This makes designing effective health-care interventions for older adults with HIV in the UK problematic. This thesis aims to identify differences in physical, social, and mental well-being in PWH in relation to age, and time diagnosed with HIV. Using one multi-centre UK study (the ASTRA study; N=3,258), one smaller study (the Resilience study, N=327) and two systematic reviews. It reveals that physical symptom frequency and distress did not differ in prevalence with age, although the symptoms of concern did. Social support decreased with age and problems with activities of daily living increased, but mental health (assessed by depression and anxiety symptoms) improved. Time with diagnosed HIV, however, was found to be strongly related to worse physical, mental, and social well-being. This is novel data and would benefit from further research to identify the extent of its effect on well-being. A second study was designed and utilised to explore these conflicting findings, and 'resilience' (assessed via the RS-14 scale) was found to relate to the increase in mental health with age, as well as the reduction in well-being identified in adults with long-term HIV. This data is the first of its kind. The results are used to suggest appropriate intervention content for adults ageing with HIV.
Supervisor: Sherr, L. ; Lampe, F. ; Rodger, A. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available