Advertisement

AIDS and Behavior

, Volume 18, Issue 4, pp 661–675 | Cite as

Evidence Informing the Intersection of HIV, Aging and Health: A Scoping Review

  • Lori A. Chambers
  • Michael G. Wilson
  • Sergio Rueda
  • David Gogolishvili
  • Maggie Qiyun Shi
  • Sean B. Rourke
  • The Positive Aging Review Team
Substantive Review

Abstract

The growing number of people over age 50 with HIV requires research, policy, and practice to develop a more comprehensive understanding of the health consequences of HIV in older individuals. We conducted a scoping review of peer-reviewed and grey literature published since 1996 to explore the impacts of aging on the health of older people with HIV (50 years or older). We included 209 studies (two systematic reviews, 174 quantitative studies, 28 qualitative studies, and five mixed methods studies). Health topics addressed include: HIV- and aging-related comorbidities, disease progression, neurocognitive functioning, mental health conditions, psychological well-being, social supports, stigma, antiretroviral adherence, health care utilization/access, and sexual risk behaviour. We recommend that future research takes a broader view of health, looks at aging from a strength-based perspective and examines the issue using diverse perspectives (i.e., geographic location, multiple methods, time of diagnosis, time on antiretroviral therapy (ART), demographic diversity).

Keywords

Aging Health Health care utilization Social participation Sexual health 

Resumen

El creciente número de personas mayores de 50 años que viven con VIH requiere que la investigación, la política y la práctica desarrollen un entendimiento más amplio de las consecuencias del VIH sobre la la salud de las personas de edad mas avanzada. Se realizó una revisión de alcance (“scoping review”) del material publicado en revistas especializadas y la literatura gris, desde 1996, para explorar el efecto del envejecimiento en la salud de las personas mayores con VIH (50 años o más). Se incluyeron 209 estudios (dos revisiones sistemáticas, 174 estudios cuantitativos, 28 estudios cualitativos, y cinco estudios de métodos mixtos). Los temas de salud abordados incluyeron: comorbilidades relacionadas con el envejecimiento y el VIH, progresión de la enfermedad, funcionamiento neurocognitivo, salud mental, bienestar psicologico, apoyos sociales, estigma, adherencia a medicaciones antirretrovirales, uso/acceso a servicios de salud y conductas sexuales de riesgo. Se recomienda que la investigación futura aborde una visión más amplia de la salud, considere el envejecimiento desde una perspectiva basada en fortalezas o destrezas y examine el tema desde perspectivas diversas (es decir, que tome en cuenta la ubicación geográfica, métodos múltiples, el momento del diagnóstico, la duración del tratamiento y la diversidad demográfica).

Notes

Acknowledgments

This report was funded through the Knowledge Synthesis grant provided by the Canadian Institutes of Health Research (CIHR) and through in-kind funding provided by the Ontario HIV Treatment Network (OHTN). We would like to thank Angela Eady for providing her librarian expertise in developing the search strategy for this review and for locating literature. We would also like to thank the following reviewers for their assistance on screening, reviewing and categorizing the literature, and summarizing the findings: David Nico Baker, Olivia Lee, Sara Morassaei, Kate Palbom, Nahid Qureshi, Elmira Raeifar, and Sarah Tumaliuan. Lastly, we would also like to acknowledge the joint efforts of the Positive Aging Review Team, collaboration between people with HIV, community-based agency representatives, health care providers, policy makers, educators, and researchers.

Conflict of interest

The authors declare they have no competing interests.

Supplementary material

10461_2013_627_MOESM1_ESM.docx (134 kb)
Supplementary material 1 (DOCX 134 kb)

References

  1. 1.
    Karpiak SE, Shippy RA, Cantor M. Research on older adults with HIV. New York: AIDS Community Research Initiative of America; 2006.Google Scholar
  2. 2.
    World Health Organization. Impact of HIV/AIDS on older people in Africa: WHO. http://www.who.int/ageing/projects/hiv/en/index.html (2012). Accessed 24 May 2012.
  3. 3.
    Centers for Disease Control and Prevention. Diagnoses of HIV infection among adults aged 50 years and older in the United States and dependent areas, 2007–2010. HIV Surveillance Supplemental Report. http://www.cdc.gov/hiv/library/reports/surveillance/index.html (2013). Accessed 15 May 2013.
  4. 4.
    Effros RB, Fletcher CV, Gebo K, Halter JB, Hazzard WR, Horne FM, et al. Workshop on HIV infection and aging: what is known and future research directions. Clin Infect Dis. 2008;47(4):542–53.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Public Health Agency of Canada. HIV/AIDS Epi Updates N. HIV/AIDS Epi Updates, November 2007. Ottawa: Surveillance and Risk Assessment Division, Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada; 2007.Google Scholar
  6. 6.
    AVERTing HIV and AIDS. United Kingdom statistics by race, age and gender: AVERT. http://www.avert.org/uk-race-age-gender.htm (2010). Accessed 25 May 2012.
  7. 7.
    Terrence Higgins Trust (THT): Information resources: HIV and AIDS: Personal experiences of HIV: 50 plus London, UK: Author. http://www.tht.org.uk/informationresources/hivandaids/personal-experiences-of-hiv/50plus/ (2012). Accessed 25 May 2012.
  8. 8.
    Health Protection Agency. United Kingdom: New HIV Diagnoses data to end December 2011. Tables No.2:2011 (2012). http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1237970242135. Accessed 8 Apr 2012.
  9. 9.
    Public Health Agency of Canada. HIV and AIDS in Canada. Surveillance Report to December 31, 2009. Ottawa: Surveillance and Risk Assessment Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada; 2010.Google Scholar
  10. 10.
    Health Protection Agency (HPK). HIV in the United Kingdom: 2008 Report. London: HPK; 2008.Google Scholar
  11. 11.
    Mutevedzi PC, Newell ML. A missing piece in the puzzle: HIV in mature adults in sub-Saharan Africa. Future Virol. 2011;6(6):755–67.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Pearline RV, Tucker JD, Yuan LF, Bu J, Yin YP, Chen XS, et al. Sexually transmitted infections among individuals over fifty years of age in China. AIDS Patient Care STDs. 2010;24(6):345.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Negin J, Cumming RG. HIV infection in older adults in sub-Saharan Africa: extrapolating prevalence from existing data. Bull WHO. 2010;88(11):847–53.PubMedCentralPubMedGoogle Scholar
  14. 14.
    Brasileiro M, Freitas MIF. Social representations about AIDS in people over 50, infected by HIV. Revista Latino-Americana de Enfermagem (RLAE). 2006;14(5):789–95.CrossRefGoogle Scholar
  15. 15.
    Canadian Working Group on HIV and Rehabilitation. HIV and aging background paper for the partners in Aging National Forum. 6th Canadian HIV/AIDS Skills Building Symposium, Montreal, QC2010, 22 Feb 2010.Google Scholar
  16. 16.
    Önen NF, Overton ET. HIV and aging: two converging epidemics. Mo Med. 2009;106(4):269–73.PubMedGoogle Scholar
  17. 17.
    High KP, Brennan-Ing M, Clifford DB, Cohen MH, Currier J, Deeks SG, et al. HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH Office of AIDS Research by the HIV and aging working group. J Acquir Immune Defic Syndr. 2012;60(Suppl 1):S1–18.PubMedCrossRefGoogle Scholar
  18. 18.
    Gebo KA. HIV and aging: implications for patient management. Drugs Aging. 2006;23(11):897–913.PubMedCrossRefGoogle Scholar
  19. 19.
    Shah S, Mildvan D. HIV and aging. Curr Infect Dis Rep. 2006;8(3):241–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Gonzalez R, Cherner M. Co-factors in HIV neurobehavioural disturbances: substance abuse, hepatitis C and aging. Int Rev Psychiatry. 2008;20(1):49–60.PubMedCrossRefGoogle Scholar
  21. 21.
    Capeau J. From lipodystrophy and insulin resistance to metabolic syndrome: HIV infection, treatment and aging. Curr Opin HIV AIDS. 2007;2(4):247–52.PubMedCrossRefGoogle Scholar
  22. 22.
    Casau NC. Perspective on HIV infection and aging: emerging research on the horizon. Clin Infect Dis. 2005;41(6):855–63.PubMedCrossRefGoogle Scholar
  23. 23.
    Smith RD, Delpech VC, Brown AE, Rice BD. HIV transmission and high rates of late diagnoses among adults aged 50 years and over. AIDS. 2010;24(13):2109–15.PubMedCrossRefGoogle Scholar
  24. 24.
    Mutevedzi PC, Lessells RJ, Rodger AJ, Newell M-L. Association of age with mortality and virological and immunological response to antiretroviral therapy in rural South African adults. PLoS One. 2011;6(7):e21795.PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Althoff K, Justice A, Gange S, Deeks S, Saag M, Silverberg M, et al. Virologic and immunologic response to HAART, by age and regimen class. AIDS. 2010;24(16):2469–79.PubMedCentralPubMedCrossRefGoogle Scholar
  26. 26.
    Grabar S, Kousignian I, Sobel A, Le Bras P, Gasnault J, Enel P, et al. Immunologic and clinical responses to highly active antiretroviral therapy over 50 years of age. Results from the French Hospital Database on HIV. AIDS. 2004;18(15):2029–38.PubMedCrossRefGoogle Scholar
  27. 27.
    Peate I. Human immunodeficiency virus and the older person. Br J Nurs. 2007;16(10):606–10.PubMedGoogle Scholar
  28. 28.
    Vance DE, Struzick TC. Addressing risk factors of cognitive impairment in adults aging with HIV: a social work model. J Gerontol Soc Work. 2007;49(4):51–77.PubMedCrossRefGoogle Scholar
  29. 29.
    Valcour V, Shikuma C, Shiramizu B, Watters M, Poff P, Selnes O, et al. Higher frequency of dementia in older HIV-1 individuals: the Hawaii aging with HIV-1 cohort. Neurology. 2004;63(5):822–7.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    McMurtray A, Nakamoto B, Shikuma C, Valcour V. Cortical atrophy and white matter hyperintensities in HIV: the Hawaii Aging with HIV Cohort Study. J Stroke Cerebrovasc Dis. 2008;17(4):212–7.PubMedCentralPubMedCrossRefGoogle Scholar
  31. 31.
    Valcour V, Shikuma C, Shiramizu B, Watters M, Poff P, Selnes OA, et al. Age, apolipoprotein E4, and the risk of HIV dementia: the Hawaii aging with HIV cohort. J Neuroimmunol. 2004;157(1–2 Spec Iss):197–202.PubMedCrossRefGoogle Scholar
  32. 32.
    Vance DE, Moneyham L, Farr KF. Suicidal ideation in adults aging with HIV: neurological and cognitive considerations. J Psychosoc Nurs Ment Health Serv. 2008;46(11):33–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Heckman TG, Kochman A, Sikkema KJ. Depressive symptoms in older adults living with HIV disease: application of the chronic illness quality of life model. J Ment Health Aging. 2002;8(4):267–79.Google Scholar
  34. 34.
    Shippy RA, Karpiak SE. Aging HIV/AIDS population: fragile social networks. Aging Ment Health. 2005;9(3):246–54.PubMedCrossRefGoogle Scholar
  35. 35.
    Emlet CA. An examination of the social networks and social isolation in older and younger adults living with HIV/AIDS. Health Soc Work. 2006;31(4):299–308.PubMedCrossRefGoogle Scholar
  36. 36.
    Vance DE, Moneyham L, Fordham P, Struzick TC. A model of suicidal ideation in adults aging with HIV. J Assoc Nurses AIDS Care. 2008;5:375–84.CrossRefGoogle Scholar
  37. 37.
    Shippy RA, Karpiak SE. Perceptions of support among older adults with HIV. Res Aging. 2005;27(3):290–306.CrossRefGoogle Scholar
  38. 38.
    Vance DE, Woodley RA. Strengths and distress in adults who are aging with HIV: a pilot study. Psychol Rep. 2005;96(2):383–6.PubMedCrossRefGoogle Scholar
  39. 39.
    Schrimshaw EW, Siegel K. Perceived barriers to social support from family and friends among older adults with HIV/AIDS. J Health Psychol. 2003;8(6):738–52.PubMedCrossRefGoogle Scholar
  40. 40.
    Schmid GP, Williams BG, Garcia-Calleja JM, Miller C, Segar E, Southworth M, et al. The unexplored story of HIV and ageing. Bull WHO. 2009;87(3):162. doi: 10.2471/BLT.09.064030.PubMedCentralPubMedGoogle Scholar
  41. 41.
    Schick V, Herbenick D, Reece M, Sanders SA, Dodge B, Middlestadt SE, et al. Sexual behaviors, condom use, and sexual health of Americans over 50: implications for sexual health promotion for older adults. J Sex Med. 2010;7:315–29.PubMedCrossRefGoogle Scholar
  42. 42.
    Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. New Engl J Med. 2007;357(8):762–74.PubMedCentralPubMedCrossRefGoogle Scholar
  43. 43.
    Lovejoy TI, Heckman TG, Sikkema KJ, Hansen NB, Kochman A, Suhr JA, et al. Patterns and correlates of sexual activity and condom use behavior in persons 50-plus years of age living with HIV/AIDS. AIDS Behav. 2008;6:943–56.CrossRefGoogle Scholar
  44. 44.
    Cooperman NA, Arnsten JH, Klein RS. Current sexual activity and risky sexual behavior in older men with or at risk for HIV infection. AIDS Educ Prev. 2007;19(4):321–33.PubMedCentralPubMedCrossRefGoogle Scholar
  45. 45.
    Crum NF, Furtek KJ, Olson PE, Amling CL, Wallace MR. A review of hypogonadism and erectile dysfunction among HIV-infected men during the pre- and post-HAART eras: diagnosis, pathogenesis, and management. AIDS Patient Care STDs. 2005;19(10):655–71.PubMedCrossRefGoogle Scholar
  46. 46.
    Centers for Disease Control and Prevention. CDC HIV/AIDS Facts: HIV/AIDS among persons aged 50 and older [Fact Sheet]. Atlanta: US: DHHS, CDC, 2008.Google Scholar
  47. 47.
    Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.CrossRefGoogle Scholar
  48. 48.
    Mays N, Roberts E, Popay J. Synthesising research evidence. In: Fulop N, Allen P, Clarke A, Black N, editors. Studying the organisation and delivery of health services: research methods. London: Routlidge; 2001. p. 188–220.Google Scholar
  49. 49.
    Straus SE, Holroyd-Leduc J. Knowledge-to-action cycle. Evid Based Med. 2008;13(4):98–100.PubMedCrossRefGoogle Scholar
  50. 50.
    Shea B, Grimshaw J, Wells G, Boers M, Andersson N, Hamel C, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007;7(1):10–6.PubMedCentralPubMedCrossRefGoogle Scholar
  51. 51.
    Oxman AD, Fretheim A, Schünemann HJ. Improving the use of research evidence in guideline development: introduction. Health Res Policy Syst. 2006;4(1):12.PubMedCentralPubMedCrossRefGoogle Scholar
  52. 52.
    Canadian Coordinating Office for Health Technology Assessment. Evaluation tools for COMPUS. http://www.cadth.ca/media/compus/pdf/COMPUS_Evaluation_Methodology_final_e.pdf: 2005.
  53. 53.
    Kearney F, Moore AR, Donegan CF, Lambert J. The ageing of HIV: implications for geriatric medicine. Age Ageing. 2010;39(5):536–41.PubMedCrossRefGoogle Scholar
  54. 54.
    Sankar A, Nevedal A, Neufeld S, Berry R, Luborsky M. What do we know about older adults and HIV? A review of social and behavioral literature. AIDS Care. 2011;23(10):1187–207.PubMedCentralPubMedCrossRefGoogle Scholar
  55. 55.
    Cochrane Handbook for Systematic Reviews of Interventions: The Cochrane Collaboration; 2011. Available from: www.cochrane-handbook.org. Accessed 15 May 2013.
  56. 56.
    Brennan M, Strauss SM, Karpiak SE. Religious congregations and the growing needs of older adults with HIV. J Relig Spiritual Aging. 2010;22(4):307–28.CrossRefGoogle Scholar
  57. 57.
    Poindexter CC, Shippy RA. HIV diagnosis disclosure: stigma management and stigma Resistance. J Gerontol Soc Work. 2010;53(4):366–81.PubMedCrossRefGoogle Scholar
  58. 58.
    Grov C, Golub SA, Parsons JT, Brennan M, Karpiak SE. Loneliness and HIV-related stigma explain depression among older HIV-positive adults. AIDS Care. 2010;22(5):630–9.PubMedCentralPubMedCrossRefGoogle Scholar
  59. 59.
    Poindexter C, Shippy RA. Networks of older New Yorkers with HIV: fragility, resilience, and transformation. AIDS Patient Care STDs. 2008;22(9):723–33.PubMedCrossRefGoogle Scholar
  60. 60.
    Golub SA, Tomassilli JC, Pantalone DW, Brennan M, Karpiak SE, Parsons JT. Prevalence and correlates of sexual behavior and risk management among HIV-positive adults over 50. Sex Transm Dis. 2010;37(10):615.PubMedGoogle Scholar
  61. 61.
    Sacktor N, Skolasky R, Selnes OA, Watters M, Poff P, Shiramizu B, et al. Neuropsychological test profile differences between young and old human immunodeficiency virus-positive individuals. J Neurovirol. 2007;13(3):203–9.PubMedCrossRefGoogle Scholar
  62. 62.
    Valcour V, Watters M, Williams A, Sacktor N, McMurtray A, Shikuma C. Aging exacerbates extrapyramidal motor signs in the era of highly active antiretroviral therapy. J Neurovirol. 2008;14(5):362–7.PubMedCentralPubMedCrossRefGoogle Scholar
  63. 63.
    Valcour V, Yee P, Williams AE, Shiramizu B, Watters M, Selnes O, et al. Lowest ever CD4 lymphocyte count (CD4 nadir) as a predictor of current cognitive and neurological status in human immunodeficiency virus type 1 infection—the Hawaii aging with HIV cohort. J Neurovirol. 2006;12(5):387–91.PubMedCrossRefGoogle Scholar
  64. 64.
    Watters MR, Poff PW, Shiramizu BT, Holck PS, Fast KMS, Shikuma CM, et al. Symptomatic distal sensory polyneuropathy in HIV after age 50. Neurology. 2004;62(8):1378–83.PubMedCrossRefGoogle Scholar
  65. 65.
    McMurtray A, Nakamoto B, Shikuma C, Valcour V. Small-vessel vascular disease in human immunodeficiency virus infection: the Hawaii aging with HIV cohort study. Cerebrovasc Dis. 2007;24(2–3):236–41.PubMedCrossRefGoogle Scholar
  66. 66.
    Valcour V, Paul R, Neuhaus J, Shikuma C. The effects of age and HIV on neuropsychological performance. J Int Neuropsychol Soc. 2011;17(1):190–5.PubMedCentralPubMedCrossRefGoogle Scholar
  67. 67.
    Valcour V, Shikuma C, Shiramizu B, Williams A, Watters M, Grove JS, et al. Diabetes, insulin resistance, and dementia among HIV-1-infected patients. JAIDS. 2005;38(1):31–6.PubMedCentralPubMedGoogle Scholar
  68. 68.
    Braithwaite RS, Roberts MS, Chang CCH, Goetz MB, Gibert CL, Rodriguez-Barradas MC, et al. Influence of alternative thresholds for initiating HIV treatment on quality-adjusted life expectancy: a decision model. Ann Intern Med. 2008;148(3):178–85.PubMedCentralPubMedCrossRefGoogle Scholar
  69. 69.
    Oursler KK, Goulet JL, Leaf DA, Akingicil A, Katzel LI, Justice A, et al. Association of comorbidity with physical disability in older HIV-infected adults. AIDS Patient Care STDs. 2006;20(11):782–91.PubMedCrossRefGoogle Scholar
  70. 70.
    Green TC, Kershaw T, Lin H, Heimer R, Goulet JL, Kraemer KL, et al. Patterns of drug use and abuse among aging adults with and without HIV: a latent class analysis of a US Veteran cohort. Drug Alcohol Depend. 2010;110(3):208–20.PubMedCentralPubMedCrossRefGoogle Scholar
  71. 71.
    Justice AC, Zingmond DS, Gordon KS, Fultz SL, Goulet JL, King Jr, et al. Drug toxicity, HIV progression, or comorbidity of aging: does tipranavir use increase the risk of intracranial hemorrhage? Clin Infect Dis. 2008;47(9):1226–30.PubMedCrossRefGoogle Scholar
  72. 72.
    Zingmond DS, Kilbourne AM, Justice AC, Wenger NS, Rodriguez-Barradas M, Rabeneck L, et al. Differences in symptom expression in older HIV-positive patients: the veterans aging cohort 3 site study and HIV cost and service utilization study experience. J Acquir Immune Defic Syndr. 2003;33(Suppl. 2):S84–92.PubMedCrossRefGoogle Scholar
  73. 73.
    Braithwaite RS, Goulet J, Kudel I, Tsevat J, Justice AC. Quantifying the decrement in utility from perceived side effects of combination antiretroviral therapies in patients with HIV. Value Health. 2008;11(5):975–9.PubMedCentralPubMedCrossRefGoogle Scholar
  74. 74.
    Goulet JL, Fultz SL, Rimland D, Butt A, Gibert C, Rodriguez-Barradas M, et al. Aging and infectious diseases: do patterns of comorbidity vary by HIV status, age, and HIV severity? Clin Infect Dis. 2007;45(12):1593–601.PubMedCentralPubMedCrossRefGoogle Scholar
  75. 75.
    Butt AA, McGinnis K, Rodriguez-Barradas MC, Crystal S, Simberkoff M, Goetz MB, et al. HIV infection and the risk of diabetes mellitus. AIDS. 2009;23(10):1227–34.PubMedCentralPubMedCrossRefGoogle Scholar
  76. 76.
    Oursler KK, Goulet JL, Crystal S, Justice AC, Crothers K, Butt AA, et al. Association of age and comorbidity with physical function in HIV-infected and uninfected patients: results from the Veterans Aging Cohort Study. AIDS Patient Care STDs. 2011;25(1):13–20.PubMedCentralPubMedCrossRefGoogle Scholar
  77. 77.
    Nokes KM, Coleman CL, Hamilton MJ, Corless IB, Sefcik E, Kirksey KM, et al. Age-related effects on symptom status and health-related quality of life in persons with HIV/AIDS. Appl Nurs Res. 2011;24(1):10–6.PubMedCrossRefGoogle Scholar
  78. 78.
    Worm SW, De Wit S, Weber R, Sabin CA, Reiss P, El-Sadr W, et al. Diabetes mellitus, preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the data collection on adverse events of anti-HIV drugs (D:A:D Study). Circulation. 2009;119(6):805–11.PubMedCentralPubMedCrossRefGoogle Scholar
  79. 79.
    Sabin C. Response to combination antiretroviral therapy: variation by age. AIDS. 2008;22(12):1463–73.Google Scholar
  80. 80.
    Carr A, Grund B, Neuhaus J, El-Sadr WM, Grandits G, Gibert C, et al. Asymptomatic myocardial ischaemia in HIV-infected adults. AIDS. 2008;22(2):237–47.CrossRefGoogle Scholar
  81. 81.
    Popay J, Rogers A, Williams G. Rationale and standards for the systematic review of qualitative literature in health services research. Qual Health Res. 1998;8(3):341–51.PubMedCrossRefGoogle Scholar
  82. 82.
    Grypdonck MHF. Qualitative health research in the era of evidence-based practice. Qual Health Res. 2006;16(10):1371–85.PubMedCrossRefGoogle Scholar
  83. 83.
    Malterud K. The art and science of clinical knowledge: evidence beyond measures and numbers. The Lancet. 2001;358(9279):397–400.CrossRefGoogle Scholar
  84. 84.
    Barbour RS. The case for combining qualitative and quantitative approaches in health services research. J Health Serv Res Policy. 1999;4(1):39–43.PubMedGoogle Scholar
  85. 85.
    Murray J, Adam BD. Aging, sexuality, and HIV issues among older gay men. Can J Hum Sex. 2001;10(3–4):75–90.Google Scholar
  86. 86.
    Lichtenstein B. Stigma as a barrier to treatment of sexually transmitted infection in the American deep south: issues of race, gender and poverty. Soc Sci Med. 2003;57(12):2435–45.PubMedCrossRefGoogle Scholar
  87. 87.
    Gott M, Hinchliff S. How important is sex in later life? The views of older people. Soc Sci Med. 2003;56(8):1617–28.PubMedCrossRefGoogle Scholar
  88. 88.
    Heckman T, Sikkema K, Hansen N, Kochman A, Heh V. A randomized clinical trial evaluating a coping improvement group intervention for HIV-infected older adults. J Behav Med. 2009;34(Suppl 1):102–11.Google Scholar
  89. 89.
    Heckman TG, Barcikowski R, Ogles B, Suhr J, Carlson B, Holroyd K, et al. A telephone-delivered coping improvement group intervention for middle-aged and older adults living with HIV/AIDS. Ann Behav Med. 2006;32(1):27–38.PubMedCrossRefGoogle Scholar
  90. 90.
    Heckman TG, Kochman A, Sikkema KJ, Kalichman SC, Masten J, Bergholte J, et al. Pilot coping improvement intervention for late middle-aged and older adults living with HIV/AIDS in the USA. AIDS Care. 2001;13(1):129–39.PubMedCrossRefGoogle Scholar
  91. 91.
    Neundorfer MM, Camp CJ, Lee MM, Skrajner MJ, Malone ML, Carr JR. Compensating for cognitive deficits in persons aged 50 and over with HIV/AIDS: a pilot study of a cognitive intervention. J HIV/AIDS Soc Serv. 2004;3(1):79–97.CrossRefGoogle Scholar
  92. 92.
    Vance DE, Burrage J, Couch A Jr, Raper J. Promoting successful aging with HIV through hardiness: implications for nursing practice and research. J Gerontol Nurs. 2008;34(6):22–9.PubMedCrossRefGoogle Scholar
  93. 93.
    Jimenez AD. Triple jeopardy: targeting older men of color who have sex with men. J Acquir Immune Defic Syndr. 2003;33(Suppl 2):S222–5.PubMedCrossRefGoogle Scholar
  94. 94.
    Jacobs RJ, Thomlison B. Self-silencing and age as risk factors for sexually acquired HIV in midlife and older women. J Aging Health. 2009;21(1):102–28.PubMedCrossRefGoogle Scholar
  95. 95.
    Appay V, Sauce D. Immune activation and inflammation in HIV-1 infection: causes and consequences. J Pathol. 2008;214(2):231–41.PubMedCrossRefGoogle Scholar
  96. 96.
    Gandhi RT, Sax PE, Grinspoon SK. Metabolic and cardiovascular complications in HIV-infected patients: new challenges for a new age. J Infect Dis. 2012;205(suppl 3):S353–4.PubMedCentralPubMedCrossRefGoogle Scholar
  97. 97.
    Deeks SG, Verdin E, McCune JM. Immunosenescence and HIV. Curr Opin Immunol. 2012;24(4):501–6.PubMedCrossRefGoogle Scholar
  98. 98.
    Pineda JA, Alcamí J, Blanco JR, Blanco J, Boix V, Casado JL, et al. Hot immunological topics in HIV infection. J AIDS Clin Res. 2011;2(118):2.Google Scholar
  99. 99.
    Ances BM, Ortega M, Vaida F, Heaps J, Paul R. Independent effects of HIV, aging, and HAART on brain volumetric measures. JAIDS. 2012;59(5):469–77.PubMedCentralPubMedGoogle Scholar
  100. 100.
    Guaraldi G, Orlando G, Zona S, Menozzi M, Carli F, Garlassi E, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis. 2011;53(11):1120–6.PubMedCrossRefGoogle Scholar
  101. 101.
    Deeks SG. HIV infection, inflammation, immunosenescence, and aging. Annu Rev Med. 2011;62:141–55.PubMedCentralPubMedCrossRefGoogle Scholar
  102. 102.
    World Health Organization. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.Google Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Lori A. Chambers
    • 1
    • 2
  • Michael G. Wilson
    • 1
    • 3
    • 4
    • 5
  • Sergio Rueda
    • 1
    • 6
  • David Gogolishvili
    • 1
  • Maggie Qiyun Shi
    • 1
  • Sean B. Rourke
    • 1
    • 6
    • 7
  • The Positive Aging Review Team
    • 1
  1. 1.Ontario HIV Treatment NetworkTorontoCanada
  2. 2.School of Social WorkMcMaster UniversityHamiltonCanada
  3. 3.Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
  4. 4.Centre for Health Economics and Policy AnalysisMcMaster UniversityHamiltonCanada
  5. 5.McMaster Health ForumMcMaster UniversityHamiltonCanada
  6. 6.Department of PsychiatryUniversity of TorontoTorontoCanada
  7. 7.Centre for Research on Inner City HealthKeenan Research Center, Li Ka Shing Knowledge Institute, St. Michael’s HospitalTorontoCanada

Personalised recommendations