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Background: Due largely to the advances of antiretroviral therapy, HIV has been transformed into a manageable, chronic condition leading to the emergence of a large population aging with this disease. However, the quality of life in adults aging with HIV is in question due to medical complications, co-morbidities, substance use, poorer mental health, social isolation, as well as stigmatization.[i] Yet, successful aging in older adults with HIV is possible[ii]with interventions that increase hardiness and resilience. It is important to encourage and translate research findings for those not successfully aging.
[i] Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA. 2005;294:716–24. [PubMed]
[ii] Vance DE, Bayless H, Kempf MC, Keltner NL, Fazeli PL. Aging, HIV, and Wellness: Augmenting the components of successful aging. Aging Health. 2011;7:435–446.
Program background: To address this need, Walgreens developed Well Beyond HIV™, an evidenced-based campaign designed to inspire dialogue, eradicate stigmas of those 50+ living with HIV. The centerpiece of the campaign is a traveling art exhibition that provides a glimpse into the lives of older adults living with HIV. Their portraits and stories show how HIV strikes an assortment of incomes, sexualities and life stories.
Evaluation Methods and Results: To guide development, the campaign drew on relevant constructs from behavior change theories and models that support the effective strategies for influencing attitudes and behavior. These included the AIDS risk reduction model[i] and Social Cognitive Theory[ii]. Formative research using qualitative methods also guided the development of the campaign, and was used to understand what elements can increase hardiness and resilience in older adults, as well as how these positive traits and perceptions related to self-management of health. Research included:
- In-depth interviews with 15 local AIDS Service Organizations from 10 states reporting higher rates of persons living with a diagnosis of HIV (45+ years)[iii].
[i] Fisher, Jeffrey D., "Changing AIDS - Risk Behavior" (1992). CHIP Documents. Paper 2. http://digitalcommons.uconn.edu/chip_docs/2
[ii] Bandura, A. Social foundations of thought and action: a social cognitive theory. Prentice Hall, Englewood Cliffs NJ; 1986
[iii] HIV and AIDS in the United States by Geographic Distribution. (2015). Retrieved March 14, 2016, from http://www.cdc.gov/hiv/statistics/overview/geographicdistribution.html
Conclusions: The overall strategic approach and campaign implementation were guided by the formative research. The team concluded the campaign should be a departure from current education programs. Instead, campaign planners created an authentic storytelling platform specifically tailored for an older adult population emphasizing hardiness and resilience in older adults with HIV.
Implications for research and/or practice:
- Tailor messages for older adults. Give the "face of HIV/AIDS" gray hair but don't stop at including pictures of older adults in brochures. Instead, address issues of aging and coping with challenges.
- Dispel myths. The importance of overcoming denial on the part of both those involved in treatment and those providing services for the elderly cannot be overstressed.