Abstract
BackgroundDespite the severe impact of HIV in sub-Saharan Africa, the health of older people aged 50+ is often overlooked owing to the dearth of data on the direct and indirect effects of HIV on older people’s health status and well-being. The aim of this study was to examine correlates of health and well-being of HIV-infected older people relative to HIV-affected people in rural South Africa, defined as participants with an HIV-infected or death of an adult child due to HIV-related cause.MethodsData were collected within the Africa Centre surveillance area using instruments adapted from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE). A stratified random sample of 422 people aged 50+ participated. We compared the health correlates of HIV-infected to HIV-affected participants using ordered logistic regressions. Health status was measured using three instruments: disability index, quality of life and composite health score.ResultsMedian age of the sample was 60 years (range 50–94). Women HIV-infected (aOR 0.15, 95% confidence interval (CI) 0.08–0.29) and HIV-affected (aOR 0.20, 95% CI 0.08–0.50), were significantly less likely than men to be in good functional ability. Women’s adjusted odds of being in good overall health state were similarly lower than men’s; while income and household wealth status were stronger correlates of quality of life. HIV-infected participants reported better functional ability, quality of life and overall health state than HIV-affected participants.Discussion and conclusionsThe enhanced healthcare received as part of anti-retroviral treatment as well as the considerable resources devoted to HIV care appear to benefit the overall well-being of HIV-infected older people; whereas similar resources have not been devoted to the general health needs of HIV uninfected older people. Given increasing numbers of older people, policy and programme interventions are urgently needed to holistically meet the health and well-being needs of older people beyond the HIV-related care system.
Highlights
Despite the severe impact of HIV in sub-Saharan Africa, the health of older people aged 50+ is often overlooked owing to the dearth of data on the direct and indirect effects of HIV on older people’s health status and well-being
We found that older people who were HIV-affected via having an adult household member who was HIV positive were associated with higher adjusted odds of reporting higher functional ability, quality of life and overall health state, compared to older people who were HIV-affected through a recent HIV-related death of an adult household member
There is need for policy interventions and a change of societal norms regarding paid work and unpaid family work to ensure women are not overburdened with care responsibilities, which contributes to their poorer health status in later life
Summary
Despite the severe impact of HIV in sub-Saharan Africa, the health of older people aged 50+ is often overlooked owing to the dearth of data on the direct and indirect effects of HIV on older people’s health status and well-being. The aim of this study was to examine correlates of health and well-being of HIV-infected older people relative to HIV-affected people in rural South Africa, defined as participants with an HIV-infected or death of an adult child due to HIV-related cause. South Africa is in the midst of a health transition characterised by four disease burdens: communicable, perinatal and maternal mortality, injury-related and non-communic able diseases [1,2,3]. The latter burden is a result of demographic transition largely characterised by declines in. In this paper we aimed to examine the correlates of health and well-being of HIV-infected older people aged 50 years and above, relative to their HIV-affected peers in rural South Africa. We defined HIV-affected older people as those with an HIV-infected adult child (18– 49 years) or with an HIV-related death of an adult child between 2008 and 2010
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