Caregiving networks of older women living with HIV.

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Over half of the HIV-population in the United States is age 50 or older. Despite successful long-term management of HIV/AIDS, older people with HIV (PLWH) often live with multiple age-related comorbidities, 4+ non-HIV conditions on average. Black and Latina women, in addition to being disproportionately affected by HIV, typically have higher rates of multimorbidity. As a result, many women living with HIV (WLWH) require informal caregiving or can anticipate needing care in the future to support complex care needs. Older WLWH are an understudied group, as most HIV research targets men and younger people. Because older women of color living with HIV have intersectional marginalized identities, they often experience difficulty in meeting their needs for caregiving and support. The configuration of older WLWH's care networks, their effectiveness in meeting older WLWH's care needs, and links to mental and behavioral health are major gaps in the HIV/AIDS literature. Similarly, there is limited understanding of the evolution of care needs and informal care networks in tandem over time, as well as the factors that shaped both in this population. This mixed-methods research seeks to use survey and interview data to investigate the adequacy of older WLWH's care networks. Aim 1 will identify inadequate care networks among Black and Latina-identifying women age 50 and older living with HIV and their association with mental and behavioral health using data from a psychosocial and egocentric network survey. Aim 2 will probe participant perspectives on their own care needs and resources, including informal and formal sources of support, and how these have changed over time through a semi-structured life history interview. Aim 3 will corroborate care network patterns and the factors associated with inadequate care networks across survey data and qualitative interviews. This research study is complemented by the career development plan which combines didactic and experiential learning through interactions with a committee of experienced mentors who are leaders in HIV and aging research to achieve four training aims: 1) acquire subject-matter expertise on WLWH; 2) expand skills in survey research and mixed methods analysis; 3) obtain content knowledge about public health scientific methods, namely causal inference; and 4) understand the translational research pipeline. The proposed research and training plan will provide the candidate with the subject-matter expertise, community partnerships, and methodological skills to conduct translational research in the HIV and aging field. This research also lays the groundwork for a long-term research agenda aimed at better understanding of the mechanisms whereby informal care networks operate across different populations of PLWH, and how to better support these individuals, reduce health disparities, and promote healthy aging through the development of targeted interventions.