Intergenerational Intervention: Employing Youth to Promote Aging Healthy with HIV in Rural South Africa

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PROJECT SUMMARY: South Africa’s rapidly growing population of older adults living with HIV (OPLHV) have suboptimal HIV-related outcomes, as they face a concomitant rise in levels of disability and chronic disease on top of a lack of HIV care and treatment interventions explicitly targeting older populations. With few alternatives to family-based care, most older Africans age in place, but with the “hollowed out” middle generation and high rates of labor migration, there is need to look elsewhere to seek the multi-dimensional support needed to age healthily. The proposed project aims to explore how an innovative intergenerational intervention could improve approaches to the management of HIV and related co-morbidities among OPLHV while offering opportunity to the younger generation in South Africa, where youth unemployment is a national concern, by employing youth to assist OPLHV in their communities. To shape early intervention development, the proposed formative and sequential mixed methods study aims to: 1) Identify the determinants of social support associated with aging healthy with HIV by gender and across the later life course—including ART management, management of multimorbidities, and life satisfaction—and how that support is moderated by household structure and composition, through longitudinal analysis of existing quantitative data from the NIH-funded study, Health and Aging in Africa: Longitudinal Studies of an INDEPTH Community; and 2) Elucidate how social support gaps can be strategically filled intergenerationally and inform a feasible intervention. This aim will be met using qualitative data with key intervention stakeholders, including a) in-depth interviews with older adults and their household member(s); b) semi-structured interviews with key informants from the community; and c) focus group discussions with youth. This project responds to the need to prepare for the growing population of adults aging with HIV and related co-morbidities while increasing the evidence base to support the design of interventions for OPLHV in diverse settings and subpopulations.