People over 50 are doing what?!?!

Intimacy. It happens. People just don’t talk about it. The stigma and aversion of openly discussing sexual health and education is proving to be a problem and a major cause of concern in public health among the aging population. The CDC estimates that in 2005 people over the age of 50 accounted for 15% of the newly diagnosed cases of HIV/AIDS (CDC, 2005). That segment of the population represents 24% of the total amount of people living with HIV/AIDS, an increase of 7% from 2001 (CDC, 2005).

Being diagnosed with HIV/AIDS is no longer viewed as a death sentence as it once was. With effective treatment and medication, people are now living longer and carrying out normal everyday activities. So why are they at an increased risk? A review of 17 research studies conducted by Savasta in 2004 suggested three factors that were greatly associated with increased rate of HIV transmission among the aging population. They included: 1) poor and inadequate education regarding HIV and its modes of transmission 2) lack/low perceptivity of risk 3) lack of communication between patients and their primary health care provider (Savasta, 2004).

Adults still want to have fun! People of this age group could be entering the dating scene again, looking to explore and find a partner for emotional support. They may not understand the risk associated with HIV/AIDS and view it only as a youth epidemic. This is partially due to the lack of education programs and resources that are geared towards the aging population. Researchers have found that out of 50 states, only 15 states had public health departments that provided HIV/AIDS prevention materials towards the intended audience (Orel et. al, 2004). With insufficient knowledge, adults are less likely to protect themselves or perceive HIV as a risk, reducing their willingness to engage in safe sex practices or obtain regular screenings (CDC, 2008).

When was the last time you talked to your doctor about your sexual health? It’s not an easy topic to bring up and openly discuss with anyone. Even with physicians, people might find it rather awkward and may even be taboo in certain communities and cultures. The lack of communication between patients and their physicians regarding this issue can create complications. Physicians may misdiagnose HIV/AIDS as some of the symptoms are similar to those of normal aging (CDC, 2008). A physician’s perception that their patient is not at risk for HIV/AIDS diminishes the opportunity to talk to them about their sexual health, HIV prevention, and screenings, leading to a delay in diagnosis and treatment (CDC, 2008).

References

Centers for Disease Control. (2008). HIV/AIDS Surveillance Report,
2005. Vol. 17. Rev ed. Atlanta:1–54.

Centers for Disease Control. (2008). HIV/AIDS among Persons Aged 50 and Older. Retrieved on March 5, 2013 from http://www.cdc.gov/hiv/topics/over50/resources/factsheets/pdf/over50.pdf

Orel, N.A., Wright, J.M., & Wagner, J. (2004). Scarcity of HIV/AIDS risk-reduction materials targeting the needs of older adults among state departments of public health. The Gerontologist, 44, 693-696.

Savasta, A.M. (2004). HIV: Associated transmission risks in older adults – An integrative review of literature. Journal of the Association of Nurses in AIDS Care, 15, 50-59.

Hun, did you take your meds today? Social networks and medical adherence By Thang Vu

By Thang Vu

How often have you forgotten to take your medicine? Imagine if you needed an I-phone app to keep track of all of them. Well, you are not alone. The World Health Organization estimates that only around 50% of patients take their medications as prescribed (NCPIE, 2007). Non-adherence can affect people with diverse demographics and can lead to a myriad of problems associated with morbidity and mortality (NCPIE, 2007).  It is responsible for 125,000 deaths annually and costs the health care industry billions of dollars (NCPIE, 2007). Numerous studies have linked social support to medical adherence. But regrettably, few published studies have utilized the power of social networks to tackle this question.

Using the social network approach, the type of ties is influential in patient adherence. Granovetter argues that “weak ties are channels through which ideas, influence, or information socially distant from the ego may reach him/her” (Granovetter, 1973). In a nutshell, if a person has less invested in you, he may serve as the ideal conduit for giving support. I am just invested enough to care and not too much to sabotage or overpower your life. A study conducted by Osamor and Owumi in 2011 showed that among patients with hypertension or health complications related to hypertension, having a family member who were concerned about their condition or helpful in reminding them about taking appropriate medications corresponded to adherence rates of 61.1% and 61.5% respectively (Osamor and Owumi, 2011). However, having friends in your back pocket to remind you to take medication had the greatest effect on medication adherence (Osamor and Owumi, 2011).

While friends appeared to be protective for a chronic disease such as hypertension, for a stigmatized disease such as HIV, they may be cause for concern. Controlling the replication of HIV is linked to staying on cocktail meds. HIV medication adherence is an example where the complicated, exhausting regimen may lead to far too many med holidays and eventual permanent medication drop-outs. Kelly et. al performed a study in 2012 to analyze the role of social support networks and its effect on antiretroviral adherence among HIV infected drug users. The study showed that the participants had an average of 1.36 social network members that can be insular from outside influence. These albeit small networks were likely to have an alter that was either HIV -positive or a drug user (Kelly et. al, 2012). Among these participants, 25% had at least one person within their network who was infected with HIV and 34% had at least one drug user within their network (Kelly et. al, 2012). The clincher is small isolated networks coupled with the presence of a drug user and/or HIV infected person within the participants’ network was linked to lower rates of antiretroviral medication adherence (Kelly et. al, 2012). While it may appear intuitive to rely on those closest to us (his or her network), HIV infected friends themselves may be struggling with their own adherence and less equipped to give support for your own. Likewise, drug using is likely take over daily healthful maintenance of any kind. Using social networks to explore medication adherence is a wide open field. But medication adherence proves that no two diseases or networks are alike.

References

Granovetter, M. (May 1973). The strength of weak ties. The American Journal of
Sociology, 78(6), 1360-80.

Kelly, P.J., Ramaswamy, M., Li, X., Litwin, A.H., Berg, K.M., & Arnsten, J.H.
(2012). Social Support Networks and Primary Care Use by HIV-Infected Drug
Users. Journal of the Association of Nurses in AIDS Care, 1-10.

National Council on Patient Information and Education. (2007). Enhancing
Prescription Medicine Adherence: A National Action Plan. Retrieved December 1, 2012, from http://www.talkaboutrx.org/documents/enhancing_prescription_medicine_adherence.pdf.

Osamor, P. E., & Owumi, B.E. (2011). Factors Associated with Treatment Compliance in Hypertension in Southwest Nigeria. Journal of Health, Population, and Nutrition, 6, 619-628.