Exploration of Coping Strategies in Older, Community Dwelling, HIV Positive Individuals in Baltimore

Abstract

Background: The CDC reports that by 2015 50% of HIV-positive individuals in the U.S. will be at least 50 years old. Individuals with HIV develop more comorbid health conditions at an earlier age than those without HIV. Older adults with HIV are a sizeable, growing population. However, published qualitative data on how older adults cope with HIV, comorbid conditions, and related stressors are extremely limited. Objectives: The purpose of this exploratory study was to identify comorbid conditions and other related stressors experienced by HIV-positive community-dwelling older adults in Baltimore and to understand how they cope. Methods: Forty HIV-positive individuals aged 50 and older (range 50-69 years; male, N=17, mean age 55; female, N=23, mean age 56) affiliated with at least one of two Baltimore-based HIV support groups with older adult members were recruited via purposeful sampling and interviewed to the point of data saturation. Data were analyzed using an interpretive hermeneutic methodology and qualitative content analysis. Results: Participants experienced one or more comorbid condition (range 1-18; male mean = 7; female mean = 6). The most frequently reported comorbid conditions for both genders were hypertension 48%, depression 43%, hypercholesterolemia 38%, memory difficulties 35%, Hepatitis C 34%, and anxiety 33%. Related stressors included HIV-related fear, perceived and actual stigma, multiple medications to treat comorbid conditions, and financial concerns. Participants learned to cope with stressors by accessing support, helping selves and helping others, and tapping into one's own spirituality. Employing these strategies helped participants cope, develop hope, and work toward psychological well-being. Conclusions: Participants employed active and meaning-based coping strategies to engage in life despite HIV, comorbid conditions, and related stressors. Findings are significant because this study is among the first to give voice to older HIV-positive community dwelling individuals in Baltimore about how they cope with HIV, comorbidities, and related stressors. Nurses' increased understanding of the impact of HIV, comorbidities, and related stressors in HIV-positive older adults along with knowledge of their active and meaning-based coping strategies can lead to holistic patient care with interventions encouraging hope and psychological well-being.