HIV Treatment adherence in older adults: Role of social support and incarceration

老年人艾滋病毒治疗依从性：社会支持和监禁的作用

• 批准号: 8918409
• 负责人: Sage J. Kim
• 金额: $ 22.6万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8918409
• 关键词: Accounting; Address; Adherence; Adult; Affect; Age; Age Factors; Aging; Anti-Retroviral Agents; Caring; Characteristics; Clinical; Communities; Continuity of Patient Care; Controlled Environment; Distress; Economics; Elderly; Emotional; Family; Focus Groups; General Population; HIV; HIV Infections; HIV Seropositivity; Health; Imprisonment; Individual; Intervention; Interview; Jail; Left; Length; Life; Life Expectancy; Life Style; Outcome; Personal Satisfaction; Persons; Pharmaceutical Preparations; Policies; Population; Prevalence; Prisoner; Prisons; Psychosocial Influences; Recording of previous events; Research; Resources; Role; Social Network; Social isolation; Social support; Staging; Time; United States National Institutes of Health; Virus; age related; aging population; base; career; community living; design; experience; forgetting; group intervention; improved; male; medical complication; meetings; men; pressure; programs; psychosocial; recidivism; social stigma; transmission process; treatment adherence

DESCRIPTION: By 2030, one-third of the US prison population will be over age 50. Meanwhile, the HIV prevalence rate in corrections is four times higher than in the general population and older adults are an increasing proportion of these higher rates. Nonetheless, little is known about the barriers and facilitators to successful HIV treatment adherence that older inmates confront after being released from correctional settings where HIV treatment may be readily available and more easily maintained. The proposed study is designed to examine how older adulthood, having been incarcerated, and the correlates of HIV affect adherence to HIV medication and the psychosocial well-being of people living with HIV who are over age 50 and have been released from prison or jail in the last five years. AIM 1 of the study is to identify barriers and facilitators to adherence to ARV specific to older adults with HIV infection who have a history of incarceration through in-depth interviews with 30 HIV-positive former inmates (over age 50) who have a history of incarcerations in the last 5 years. This aim will include exploring differences in three groups, stratified by length of time since their release from the last incarceration. AIM 2 is to characterize the post-release experiences and the social support networks (types, size, and their social roles) of these older former inmates and the influence of these psychosocial and economic experiences and social network characteristics on meeting the challenges and/or exacerbating the barriers to adherence to treatment and psychosocial well-being. Using findings from Aims 1 & 2, Aim 3 is to develop and evaluate through focus groups a community- based, group intervention to support and increase adherence to treatment among older adults with HIV with a history of incarceration. The impact of this study lies in its promise of providing critical information on post- release experiences which could be barriers and facilitators to successful HIV treatment adherence among a rapidly growing but largely forgotten subpopulation of older adults living with HIV with a history of incarceration.

描述：到2030年，美国三分之一的监狱人口将超过50岁。与此同时，监狱中的艾滋病毒流行率是普通人群的四倍，老年人在这些较高的感染率中所占的比例越来越高。尽管如此，人们对老年囚犯从管教环境中释放后所面临的成功坚持艾滋病毒治疗的障碍和促进者知之甚少，在那里，艾滋病毒治疗可能很容易获得和更容易维持。这项拟议的研究旨在研究被监禁的成年人和艾滋病毒的相关性如何影响50岁以上并在过去五年内从监狱或监狱释放的艾滋病毒携带者坚持使用艾滋病毒药物和心理社会福祉。这项研究的目的1是通过对30名艾滋病毒阳性(50岁以上)、过去5年有监禁史的艾滋病毒阳性前囚犯的深入访谈，确定特定于有监禁史的艾滋病毒感染的老年人遵守抗逆转录病毒病毒的障碍和促进者。这一目标将包括探索三组人之间的差异，根据他们自上次监禁获释以来的时间长短进行分层。目标2是描述这些年长的前囚犯的释放后经历和社会支持网络(类型、规模及其社会角色)，以及这些心理社会和经济经历以及社会网络特征对应对挑战和/或加剧坚持治疗和心理社会福祉的障碍的影响。利用目标1和目标2的调查结果，目标3旨在通过重点小组制定和评估以社区为基础的团体干预措施，以支持和提高有监禁史的艾滋病毒老年患者的治疗依从性。这项研究的影响在于，它承诺提供关于出院后经历的关键信息，这可能是在快速增长但基本上被遗忘的有监禁史的艾滋病毒携带者老年群体中成功坚持艾滋病毒治疗的障碍和促进者。