Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-24T13:14:13.554Z Has data issue: false hasContentIssue false

Ageing with HIV/AIDS: a scoping study among people aged 50 and over living in Quebec

Published online by Cambridge University Press:  15 June 2012

ISABELLE WALLACH*
Affiliation:
Département de sexologie, Université du Québec à Montréal, Montréal, Canada.
SHARI BROTMAN
Affiliation:
School of Social Work, McGill University, Montréal, Canada.
*
Address for correspondence: Isabelle Wallach, Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada. E-mail: [email protected]

Abstract

The population of people aged 50 and over represents a significant proportion of people living with HIV in Western nations. While the number of older people living with HIV is rapidly increasing in Canada, research originating in this country remains relatively scarce. This article therefore proposes to describe the impact of the intersection of HIV and ageing on the identities and lived experiences of people living with HIV of 50 and over (PLHIV50+), both on an individual and social level, in order to offer a picture of their lived experience. Using a phenomenological approach, nine semi-structured individual interviews with PLHIV50+ (men and women) were undertaken. Data analysis identified several central themes which constituted the essence of their experience of the intersection of HIV and ageing, such as the experience of premature ageing, the impact of HIV on intergenerational relationships, the shrinking of one's social network, rejection experienced by the older population, a difficult return to work and a deterioration in living conditions. The results of this research highlight the many challenges faced by PLHIV50+, on physical, relational, work and economic levels. Even though some of the problems faced by PLHIV50+ were related to the experience of corporal changes and a deterioration of health, our research was able to highlight the societal and structural factors underlying the stigma of HIV and ageing.

Type
Articles
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altschuler, J., Katz, A. D. and Tynan, M. 2004. Developing and implementing an HIV/AIDS educational curriculum for older adults. The Gerontologist, 44, 1, 121–6.Google Scholar
Anthias, F., Yuval-Davis, N. and Cain, H. 1992. Racialized Boundaries: Race, Nation, Gender, Colour, and Class and the Anti-racist Struggle. Routledge, London.Google Scholar
Aronson, J. and Neysmith, S. M. 2001. Manufacturing social exclusion in the home care market. Canadian Public Policy – Analyse de Politiques, 27, 2, 151–65.Google Scholar
Bannerji, H. 1995. Think Through: Essays on Feminism, Marxism and Anti-racism. Women's Press, Toronto.Google Scholar
Beharry, P. and Crozier, S. 2008. Using phenomenology to understand experiences of racism for second-generation South Asian women. Canadian Journal of Counseling, 42, 4, 262–77.Google Scholar
Biggs, S. 1997. Choosing not to be old? Masks, bodies and identity management in later life. Ageing & Society, 17, 5, 553–70.CrossRefGoogle Scholar
Bishop, A. 1994. Becoming an Ally: Breaking the Cycle of Oppression. Fernwood, Halifax, Canada.Google Scholar
Bogdan, R. C. and Biklen, S. K. 1982. Qualitative Research for Education: An Introduction to Theory and Methods. Allyn and Bacon, Boston, Massachusetts.Google Scholar
Brennan, M. and Applebaum, A. 2009. Loneliness among older adults with HIV. In Brennan, M., Karpiak, S. E., Shippy, R. A. and Cantor, M. H. (eds), Older Adults with HIV: An In-depth Examination of an Emerging Population. Nova Science Publishers, New York, 7578.Google Scholar
Brennan, M., Karpiak, S. E., Shippy, R. A. and Cantor, M. H. (eds) 2009. Older Adults with HIV: An In-depth Examination of an Emerging Population. Nova Science Publishers, New York.Google Scholar
Brotman, S. and Ryan, B. 2004. An intersectional approach to queer health policy and practice: two-spirit people in Canada. Canadian Diversity, 3, 1, 5964.Google Scholar
Brotman, S., Ryan, B. and Cormier, R. 2003. The health and social service needs of gay and lesbian elders and their families in Canada. The Gerontologist, 43, 2, 192202.Google Scholar
Bury, M. 1982. Chronic illness as biographical disruption. Sociology of Health & Illness, 4, 2, 167–82.Google Scholar
Bury, M. 1988. Meanings at risk: the experience of arthritis. In Anderson, R. and Bury, M., Living with Chronic Illness. Unwin Hyman, London, 89116.Google Scholar
Butler, R. N. 1969. Ageism: another form of bigotry. The Gerontologist, 9, 4, 243–6.Google Scholar
Caldwell, P. M. 1991. A hairpiece: perspectives on the intersection of race and gender. Duke Law Journal, 1991, 2, 365–96.CrossRefGoogle Scholar
Caradec, V. 2004. Vieillir après la retraite. Approche sociologique du vieillissement. Presses Universitaires de France, Paris.Google Scholar
Caradec, V. 2008. Sociologie de la vieillesse et du vieillissement. Armand Colin, Paris.Google Scholar
Carricaburu, D. and Pierret, J. 1995. From biographical disruption to biographical reinforcement: the case of HIV-positive men. Sociology of Health & Illness, 17, 1, 6588.Google Scholar
Cheal, D. and Kampen, K. 1998. Poor and dependent seniors in Canada. Ageing & Society, 18, 2, 147–66.CrossRefGoogle Scholar
Coon, D. W., Lipman, P. D. and Ory, M. G. 2003. Designing effective HIV/AIDS social and behavioral interventions for the population of those age 50 and older. JAIDS Journal of Acquired Immune Deficiency Syndromes, 33, 2, S194205.CrossRefGoogle ScholarPubMed
Crenshaw, K. 1995. Mapping the margins: intersectionality, identity politics, and violence against women of color. In Crenshaw, K., Gotanda, N., Peller, G. and Thomas, K. (eds), Critical Race Theory: The Key Writings that Formed the Movement. The New Press, New York, 357–83.Google Scholar
Creswell, J. 1998. Qualitative Inquiry and Research Design: Choosing Among Five Traditions. Sage, Thousand Oaks, California.Google Scholar
Creswell, J. W. and Miller, D. L. 2000. Determining validity in qualitative inquiry. Theory into Practice, 39, 3, 124–30.CrossRefGoogle Scholar
Crystal, S., Akincigil, A., Sambamoorthi, U., Wenger, N., Fleishman, J. A., Zingmond, D. S., Hays, R. D., Bozzette, S. A. and Shapiri, M. F. 2003. The diverse older HIV-positive population: a national profile of economic circumstances, social support and quality of life. JAIDS Journal of Acquired Immune Deficiency Syndromes, 33, 2, 7683.CrossRefGoogle ScholarPubMed
Csordas, T. J. 1994. Embodiment and Experience. The Existential Ground of Culture and Self. Cambridge University Press, Cambridge.Google Scholar
Delgado, R. 1995. Race, sex, class and their intersections. In Delgado, R. (ed.), Critical Race Theory: The Cutting Edge. Temple University Press, Philadelphia, 241.Google Scholar
Dray-Spira, R., Gueguen, A., Ravaud, J. F. and Lert, F. 2007. Socioeconomic differences in the impact of HIV infection on workforce participation in France in the era of highly active antiretroviral therapy. American Journal of Public Health, 97, 3, 552–8.Google Scholar
Duncan, C. 2003. Assessing anti-ageism routes to older worker re-engagement. Work, Employment & Society, 17, 1, 101–20.Google Scholar
Emlet, C. A. 1997. A hidden population. Home Care Provider, 2, 2, 6975.CrossRefGoogle ScholarPubMed
Emlet, C. A. 2006 a. You're awfully old to have this disease: experiences of stigma and ageism in adults 50 years and older living with HIV/AIDS. The Gerontologist, 46, 6, 781–90.Google Scholar
Emlet, C. A. 2006 b. A comparison of HIV stigma and disclosure patterns between older and younger adults living with HIV/AIDS. AIDS Patient Care and Studies, 20, 5, 350–8.Google Scholar
Emlet, C. A. 2006 c. An examination of the social networks and social isolation in older and younger adults living with HIV/AIDS. Health and Social Work, 31, 4, 299308.Google Scholar
Emlet, C. A. 2007. Experiences of stigma in older adults living with HIV/AIDS: a mixed-methods analysis. AIDS Patient Care and Studies, 21, 10, 740–50.Google Scholar
Emlet, C. A. 2008. The impact of HIV stigma on older adults. Vital Ageing. Theme: HIV/AIDS and Aging, 14, 2, 45.Google Scholar
Featherstone, M. and Hepworth, M. 1991. The mask of ageing and the postmodern life course. In Featherstone, M., Hepworth, M. and Turner, B. S. (eds), The Body: Social Process and Cultural Theory. Sage, London, 371–89.CrossRefGoogle Scholar
Featherstone, M. and Wernick, A. 1995. Introduction. In Featherstone, M. and Wernick, A. (eds), Images of Aging. Cultural Representations of Later Life. Routledge, London, 115.Google Scholar
Fellows, M. and Razack, S. 1998. The race to innocence: confronting hierarchical relations among women. Journal of Gender, Race and Justice, 1, 335–52.Google Scholar
Finkelstein, L. M., Burke, M. J. and Raju, N. S. 1995. Age discrimination in simulated employment contexts: an integrative analysis. Journal of Applied Psychology, 80, 652–63.Google Scholar
Ford, K. and Chamrathrithirong, A. 2009. First sexual experience and current sexual behavior among older Thai men and women. Sexuality Health, 6, 3, 195202.CrossRefGoogle ScholarPubMed
Fritsch, T. 2005. HIV/AIDS and the older adult: an exploratory study of the age-related differences in access to medical and social services. The Journal of Applied Gerontology, 24, 1, 3454.Google Scholar
Furlotte, C. 2009. The health and social service experiences of eleven older adults living with HIV/AIDS in the national capital region. Paper presented at the 18ème Conférence Canadienne sur le VIH/Sida, Vancouver.Google Scholar
Goffman, E. 1968. Stigma: Notes on the Management of Spoiled Identity. Penguin, Harmondworth, UK.Google Scholar
Good, B. 1998. Comment faire de l'anthropologie médicale? Médecine, rationalité et vécu. Institut Synthélabo, Le Plessis-Robinson, France.Google Scholar
Good, B. and Delvecchio Good, M. 1980. The meaning of symptoms: a cultural hermeneutic model for clinical practice. In Kleinman, A. and Eisenberg, E. L. (eds), The Relevance of Social Science for Medicine. Reidel, Dordrecht, The Netherlands, 165–96.Google Scholar
Government of Canada 2005. Seniors on the Margins. Aging in Poverty in Canada. Available online at http://dsp-psd.pwgsc.gc.ca/Collection/H88–5–3–2005E.pdf [Accessed 16 February 2011].Google Scholar
Grenier, A. 2007. Constructions of frailty in the English language, care practice and the lived experience. Ageing & Society, 27, 3, 425–45.CrossRefGoogle Scholar
Grenier, A. and Ferrer, I. 2010. Âge, vieillesse et vieillissement: définitions controversées de l'âge. In Charpentier, M., Guberman, N., Billette, V., Lavoie, J.-P., Grenier, A. and Olazabal, I. (eds), Vieillir au Pluriel: Perspectives Sociales. Presses de l'Université du Québec, Sainte-Foy, Canada, 3554.Google Scholar
Grenier, A. and Hanley, J. 2007. Older women and ‘frailty’: aged, gendered and embodied resistance. Current Sociology, 55, 2, 211–28.Google Scholar
Grillo, T. 1995. Anti-essentialism and intersectionality: tools to dismantle the Master'house. Berkeley Journal of Gender, Law & Justice, 10, 1630.Google Scholar
Haj-Yahia, M. and Cohen, H. C. 2009. On the lived experience of battered women residing in shelters. Journal of Family Violence, 24, 2, 95109.Google Scholar
Heikkinen, R. L. 2000. Ageing in an autobiographical context. Ageing & Society, 20, 4, 467–83.Google Scholar
Herek, G. and Capitano, J.-P. 1998. Symbolic prejudice or fear of infection? A functional analysis of AIDS-related stigma among heterosexual adults. Basic and Applied Social Psychology, 20, 3, 230–41.Google Scholar
Hillman, J. 2008. Sexual issues and aging within the context of work with older adult patients. Professional Psychology: Research and Practice, 39, 3, 290–7.Google Scholar
Hosegood, V. and Timaeus, M. J. 2006. HIV/AIDS and older people in South Africa. In Cohen, B. and Menken, J. (eds), Aging in Sub-Saharan Africa: Recommendation for Furthering Research. National Academies Press, Washington DC, 250–75.Google Scholar
Hurd Clarke, L. 2002. Beauty in later life: older women's perceptions of physical attractiveness. Canadian Journal on Aging, 21, 3, 429–42.Google Scholar
IDASA 2011. HIV and an often forgotten age group: older adults. Available online at http://www.idasa.org/our_products/resources/output/hiv_and_an_often_forgotten/ [Accessed 1 November 2011].Google Scholar
Im-em, W., Van Landingham, M., Knodel, J. and Saengtienchai, J. 2002. HIV/AIDS-related knowledge and attitudes: a comparison of older persons and young adults in Thailand. AIDS Education and Prevention, 14, 3, 246–62.Google Scholar
Jones, R. L. 2006. ‘Older people’ talking as if they are not older people: positioning theory as an explanation. Journal of Aging Studies, 20, 1, 7991.CrossRefGoogle Scholar
Joyce, G. F., Goldman, D. P., Leibowitz, A. A., Alpert, A. and Bao, Y. 2005. A socioeconomic profile of older adults with HIV. Journal of Health Care for the Poor and Underserved, 16, 1, 1928.Google Scholar
Karpiak, S. E., Shippy, R. A. and Cantor, M. H. 2006. Research on Older Adults with HIV. AIDS Community Research Initiative of America, New York.Google Scholar
Katz, S. and Marshall, B. 2003. New sex for old: lifestyle, consumerism, and the ethics of ageing well. Journal of Ageing Studies, 17, 1, 316.CrossRefGoogle Scholar
Keigher, S. M., Stevens, P. E. and Plach, S. K. 2004. Midlife women with HIV: health, social and economic factors shaping their futures. In Poindexter, Cannon, C. and Keigher, S. (eds), Midlife and Older Adults and HIV. Implications for Social Service Research, Practice and Policy. Haworth Press, New York, 4358.Google Scholar
Knodel, J. E. 2008. Poverty and the impact of AIDS on older persons: evidence from Cambodia and Thailand. Economic Development and Cultural Change, 56, 2, 441–75.CrossRefGoogle Scholar
Knodel, J., VanLandingham, M., Saengtienchai, C. and Im-em, W. 2001. Older people and AIDS: quantitative evidence of the impact in Thailand. Social Science and Medicine, 52, 9, 1313–27.CrossRefGoogle ScholarPubMed
Knodel, J., Watkins, S. and VanLandingham, M. 2003. AIDS and older persons: an international perspective. JAIDS Journal of Acquired Immune Deficiency Syndromes, 33, 2, S153–65.Google Scholar
Knodel, J. E., Williams, N., Kiry Kim, S., Puch, S. and Saengtienchai, C. 2010. Community reaction to older age parental AIDS caregivers: evidence from Cambodia. Research on Aging, 32, 1, 122–51.Google Scholar
Lavigne, A. and Fortin, M.-E. 2007. La participation sociale des aînés: enjeux, débats et états des connaissances. Institut sur le vieillissement et la participation sociale des aînés de l'Université Laval, Québec.Google Scholar
Lebouché, B., Wallach, I. and Lévy, J. J. 2008. Vieillir avec le VIH: enjeux éthiques autour d'une population invisible. Éthique Publique, 10, 2, 105–16.Google Scholar
Lévy, J. J., Pierret, J. and Trottier, G. 2005. Les traitements antirétroviraux. Expériences et défis. Presses de l'Université du Québec, Sainte-Foy, Canada.Google Scholar
Malcolm, A., Aggleton, P., Bronfman, M., Galvao, J., Mane, P. and Verrall, J. 1998. HIV-related stigmatization and discrimination: its forms and contexts. Critical Public Health, 8, 4, 347–70.Google Scholar
McCann, R. M. and Giles, H. 2002. Ageism and the workplace: a communication perspective. In Nelson, T. D. (ed.), Ageism. MIT Press, Cambridge, Massachusetts, 163–99.Google Scholar
Mendès-Leite, R. and Banens, M. 2006. Vivre avec le VIH. Calmann-Lévy, Paris.Google Scholar
Moustakas, C. E. 1994. Phenomenological Research Methods. Sage, Thousand Oaks, California.Google Scholar
Mullaly, B. 2002. Challenging Oppression: A Critical Social Work Approach. Oxford University Press, New York.Google Scholar
Mutevedzi, P. C. and Newell, M.-L. 2011. A missing piece in the puzzle: HIV in mature adults in sub-Saharan Africa. Future Virology, 6, 6, 755.Google Scholar
Negin, J. and Cumming, R. G. 2010. HIV infection in older adults in sub-Saharan Africa: extrapolating prevalence from existing data. Bulletin of the World Health Organization, 1, 88, 847–53.Google Scholar
Nichols, J. E., Speer, D. C., Watson, B. J., Watson, M. R., Vergon, T. L., Vallee, C. M. and Meah, J. M. 2002. Ageing with HIV. Psychosocial, Social and Health Issues. Academic Press, San Diego, California.Google Scholar
Ogunmefun, C., Gilbert, L. and Schatz, E. 2011. Older female caregivers and HIV/AIDS-related secondary stigma in rural South Africa. Journal of Cross-cultural Gerontology, 26, 1, 85102.Google Scholar
Pierret, J. 2006. Vivre avec le VIH. Enquête de Longue Durée auprès des Personnes Infectées. Presses Universitaires de France, Paris.Google Scholar
Poindexter, C. 2004. ‘It don't matter what people say as long as I love you’: experiencing stigma when raising an HIV-infected grandchild. In Emlet, C. (ed.), HIV/AIDS and Older Adults. Challenges for Individuals, Families and Communities. Springer Publishing, New York, 131–56.Google Scholar
Poindexter, C. and Shippy, R. A. 2008. Networks of older New Yorkers with HIV: fragility, resilience, and transformation. AIDS Patient Care Studies, 22, 9, 723–33.Google Scholar
Pound, P., Gompertz, P. and Ebrahim, S. 1998. Illness in the context of older age: the case of stroke. Sociology of Health & Illness, 20, 4, 489506.CrossRefGoogle Scholar
Power, L., Bell, M. and Freemantle, I. 2010. A National Study of Ageing and HIV (50 Plus). Joseph Rowntree Foundation. Available online at www.jrf.org.uk [Accessed 11 January 2011].Google Scholar
Public Health Agency of Canada 2010. HIV/AIDS among older Canadians. HIV/AIDS Epi Update, July, 1–6. Available online at http://www.phac-aspc.gc.ca/aids-sida/publication/epi/2010/pdf/EN_Chapter6_Web.pdf [Accessed 2 September 2010].Google Scholar
Razack, S. 1998. Looking White People in the Eye: Gender, Race and Culture in Courtrooms and Classrooms. University of Toronto Press, Toronto.Google Scholar
Sanders, C., Donovan, J. and Dieppe, P. 2002. The significance and consequences of having painful and disabled joints in older age: co-existing accounts of normal and disrupted biographies. Sociology of Health & Illness, 24, 2, 227–53.Google Scholar
Sankar, A., Luborsky, M., Rwabuhemba, T. and Songwathana, P. 1998. Comparative perspectives on living with HIV/AIDS in late life. Research on Aging, 20, 6, 885911.CrossRefGoogle ScholarPubMed
Scambler, G. 1993. Epilepsy and quality of life research. Journal of the Royal Society of Medicine, 86, 8, 449–50.Google Scholar
Schmid, G. P., Williams, B. G., Garcia-Calleja, J. M., Miller, C., Segar, E., Southworth, M., Tonyan, D., Walcoff, J. and Scott, J. 2009. The unexplored story of HIV and ageing. Bulletin of the World Health Organization, 87, 162.Google Scholar
Shippy, R. A. and Karpiak, S. E. 2005. The ageing HIV/AIDS population: fragile social networks. Ageing and Mental Health, 9, 3, 246–54.Google Scholar
Solomon, K. 1996. Psychosocial issues. In Nokes, K. M. (ed.), HIV/AIDS and the Older Adult. Taylor & Francis, New York, 3346.Google Scholar
Stasiulis, D. 1990. Theorizing connections: gender, race, ethnicity and class. In Li, P. (ed.), Race and Ethnic Relations in Canada. Oxford University Press, Toronto, 269305.Google Scholar
Tesch, R. 1990. Qualitative Research: Analysis Types and Software Tools. The Falmer Press, New York.Google Scholar
UNAIDS 2009. AIDS Epidemic Update. Available online at http://data.unaids.org/pub/report/2009/jc1700_epi_update_2009_en.pdf [Accessed 31 January 2012].Google Scholar
Vannienwenhove, T. 2009. La corporéité de l'individu vieillissant. Entre images collectives et expériences individuelles. In Olazabal, I. (ed.), Que sont les baby-boomers devenus? Aspects sociaux d'une génération vieillissante. Nota Bene, Québec, Canada, 229–50.Google Scholar
Wallach, I. 2008. Editorial. Theme: HIV/AIDS and aging. Vital Aging, 14, 2, 13.Google Scholar
Williams, N., Knodel, J. and Lam, D. 2010. HIV/AIDS and older persons: shifting the focus from the infected to the affected. Research on Aging, 32, 1, 318.Google Scholar
Williams, S. J. 2000. Chronic illness as a biographical disruption or biographical disruption as a chronic illness? Reflections on a core concept. Sociology of Health and Illness, 22, 1, 4067.Google Scholar
Wilson, A. O. and Adamchak, D. J. 2001. The grandmother's disease – the impact of AIDS on Africa's older women. Age and Ageing, 30, 1, 810.Google Scholar
Wimpenny, P. and Gass, J. 2000. Interviewing in phenomenology and grounded theory: is there a difference? Journal of Advanced Nursing, 31, 6, 1485–92.Google Scholar
World Health Organization (WHO) 2002. Impact of AIDS on Older People in Africa: Zimbabwe Case Study. Available online at http://whqlibdoc.who.int/hq/2002/WHO_NMH_NPH_ALC_02.12.pdf [Accessed 1 November 2011].Google Scholar
World Health Organization (WHO) 2010. HIV/AIDS in the South-East Asia Region. Progress Report 2010. Available online at http://www.searo.who.int/LinkFiles/HIV-AIDS_HIV_report-2010–30Nov.pdf [Accessed 1 November 2011].Google Scholar
Wyatt, A. 1996. Long-term care. In Nokes, K. M. (ed.), HIV/AIDS and the Older Adult. Taylor & Francis, New York, 8194.Google Scholar