Advertisement

Journal of Cross-Cultural Gerontology

, Volume 27, Issue 1, pp 1–15 | Cite as

The Changing Impact of the AIDS Epidemic on Older-Age Parents in the Era of ART: Evidence from Thailand

  • John KnodelEmail author
Original Research

Abstract

Previous research makes clear that before antiretroviral therapy (ART), when HIV led to disabling illness and certain death, many older persons as parents of infected adults experienced adverse emotional, material and social consequences. The present study examines how widespread access to ART is transforming the situation in Thailand. Interviews with parents of adult ART recipients reveal that major improvements in the health of their adult children under treatment is associated with major reductions in parental caregiving and expenses associated with their HIV-infected child although parents continue to provide psychological support. Parents own worry about their child’s health also declines. Most adult children on ART are able to continue or resume economic activity and many contribute to support of the parental household. ART appears to reduce negative community reaction. Nevertheless, given uncertainty surrounding how long ART can protect against fatal illnesses, whether the adverse impacts of the AIDS epidemic on parents are being eliminated or only postponed remains an open question.

Keywords

AIDS and older persons: antiretroviral therapy HIV/AIDS impact Parental caregiving Parents of adults with HIV/AIDS Thailand 

Notes

Acknowledgements

This research was supported by a pilot sub-grant from the National Institute on Aging grant P30 AG012846. The author gratefully acknowledges the collaboration of Jiraporn Kespichayawattana, Chanpen Saengtienchai and Suvinee Wiwatwanich in the project that produced the data on which this study is based.

References

  1. Analyzing Development Issues (ADI). (2010). Older-age people supporting HIV/AIDS children and household relatives on antiretroviral treatment: Case study of six communes of Banteay Meanchey Province, Cambodia. Phnom Penh: Cooperation Committee of Cambodia.Google Scholar
  2. Apinundecha, C., Laohasiriwong, W., Cameron, M. P., & Lim, S. (2007). A community participation intervention to reduce HIV/AIDS stigma, Nakorn Ratchasima province, northeast Thailand. AIDS Care, 19(9), 1157–1165.CrossRefGoogle Scholar
  3. Chasombat, S., McConnell, M. S., Siangphoe, U., et al. (2009). National expansion of antiretroviral treatment in Thailand, 2000–2007: program scale-up and patient outcomes. JAIDS-Journal of Acquired Immune Deficiency Syndromes, 50(5), 506–512.CrossRefGoogle Scholar
  4. Ezekiel, M. J., Talle, A., Juma, J. M., & Klepp, K.-I. (2009). “When in the body, it makes you look fat and HIV negative”: the constitution of antiretroviral therapy in local discourse among youth in Kahe, Tanzania. Social Science & Medicine, 68(5), 957–964.CrossRefGoogle Scholar
  5. Kaler, A., Alibhai, A., Kipp, W., Rubaale, T., & Konde-Lule, J. (2010). “Living by the hoe” in the age of treatment: perceptions of household well-being after antiretroviral treatment among family members of persons with AIDS. AIDS Care, 22(4), 509–519.CrossRefGoogle Scholar
  6. Knodel, J. (2008). Poverty and the impact of AIDS on older persons: evidence from Cambodia and Thailand. Economic Development and Cultural Change, 56(2), 441–475.CrossRefGoogle Scholar
  7. Knodel, J., & Chayovan, N. (2009). Intergenerational relationships and family care and support for Thai elderly. Ageing International, 33, 15–27.CrossRefGoogle Scholar
  8. Knodel, J., & Im-em, W. (2004). The economic consequences for parents of losing an adult child to AIDS: evidence from Thailand. Social Science and Medicine, 59(5), 987–1001.CrossRefGoogle Scholar
  9. Knodel, J., & Saengtienchai, C. (2004). AIDS and older persons: The view from Thailand. In P. Lloyd-Sherlock (Ed.), Living longer: Ageing, development and social protection (pp. 249–274). London: ZED.Google Scholar
  10. Knodel, J., & VanLandingham, M. (2002). The impact of the AIDS epidemic on older persons. AIDS 2002, 16(Supplement 4), S77–S83.Google Scholar
  11. Knodel, J., & VanLandingham, M. (2003). Return migration in the context of parental assistance in the AIDS epidemic: the Thai experience. Social Science and Medicine, 57, 327–342.CrossRefGoogle Scholar
  12. Knodel, J., VanLandingham, M., Saengtienchai, C., & Im-em, W. (2001). Older people and AIDS: quantitative evidence of the impact in Thailand. Social Science and Medicine, 52(9), 1313–1327.CrossRefGoogle Scholar
  13. Knodel, J., Watkins, S., & VanLandingham, M. (2003). AIDS and older persons: an international perspective. Journal of Acquired Immunodeficiency, 33(Supplement 233), S153–S165.CrossRefGoogle Scholar
  14. Knodel, J., Zimmer, Z., Kim, S. K., & Puch, S. (2007). The effect on elderly parents in Cambodia of losing an adult child to AIDS. Population and Development Review, 33(3), 479–500.CrossRefGoogle Scholar
  15. Knodel, J., Kespichayawattana, J., Saengtienchai, C., & Wiwatwanich, S. (2010). The role of parents and family members in ART treatment adherence: evidence from Thailand. Research on Aging, 32(1), 19–39.CrossRefGoogle Scholar
  16. Kumphitak, A., Kasi-Sedapan, S., Wilson, D., Ford, N., Adpoon, P., Kaetkaew, S., et al. (2004). Involvement of people living with HIV/AIDS in treatment preparedness in Thailand: case study. Geneva: World Health Organization.Google Scholar
  17. Lee, S.-J., Li, L., Jiraphongsa, C., & Rotheram-Borus, M. J. (2010). Caregiver burden of family members of persons living with HIV in Thailand. International Journal of Nursing Practice, 16, 57–63.CrossRefGoogle Scholar
  18. Li, L., Lee, S. J., Wen, Y., Lin, C., Wan, D., & Jiraphongsa, C. (2010). Antiretroviral therapy adherence among patients living with HIV/AIDS in Thailand. Nursing and Health Sciences, 12(2), 212–220.CrossRefGoogle Scholar
  19. Liamputtong, P., Haritavorn, H., & Kiatying-Angsulee, N. (2009). HIV and AIDS, stigma and AIDS support groups: perspectives from women living with HIV and AIDS in central Thailand. Social Science and Medicine, 69(6), 862–868.CrossRefGoogle Scholar
  20. Lyttleton, C., Beesey, A., & Sitthikrienkrai, M. (2007). Expanding community through ARV provision in Thailand. AIDS Care, 19(Supplement 1), S44–S53.CrossRefGoogle Scholar
  21. Maman, S., Abler, L., Parker, L., Lane, T., Chirowodza, A., Ntogwisangu, J., et al. (2009). A comparison of HIV stigma and discrimination in five international sites: the influence of care and treatment resources in high prevalence settings. Social Science and Medicine, 68(12), 2271–2278.CrossRefGoogle Scholar
  22. Moore, A. R. (2007). Older poor parents who lost an adult child to AIDS in Togo, West Africa: a qualitative study. Omega: The Journal of Death and Dying, 56, 289–302.CrossRefGoogle Scholar
  23. Moore, A. R., & Henry, D. (2005). Experiences of older informal caregivers to people living with HIV/AIDS in Lomé, Togo. Ageing International, 30(2), 147–166.CrossRefGoogle Scholar
  24. Ogden, J., & Nyblade, L. (2005). Common at its core: HIV-related stigma across contexts. Washington, DC: International Center for Research on Women.Google Scholar
  25. Orbach, D. (2007). Committed to caring: Older women and HIV and AIDS in Cambodia, Thailand and Vietnam. London: HelpAge International.Google Scholar
  26. Rotheram-Borus, M. J., Stein, J. A., Jiraphongsa, C., et al. (2010). Benefits of family and social relationships for Thai parents living with HIV. Prevention Science, 11(3), 298–307.CrossRefGoogle Scholar
  27. Roura, M., Urassa, M., Busza, J., Mbata, D., Wringe, A., & Zaba, B. (2009). Scaling up stigma? The effects of antiretroviral roll-out on stigma and HIV testing: early evidence from rural Tanzania. Sexually Transmitted Infections, 85(4), 308–312.CrossRefGoogle Scholar
  28. Ssengonzi, R. (2009). The impact of HIV/AIDS on the living arrangements and well-being of elderly caregivers in rural Uganda. AIDS Care, 21(3), 309–314.CrossRefGoogle Scholar
  29. UNAIDS. (2010). Global report: UNAIDS report on the Global Aids Epidemic 2010. Geneva: UNAIDS.Google Scholar
  30. UNGASS. (2010). UNGASS Country Progress Report. Thailand. Reporting period: January 2008–December 2009. Geneva: UNAIDS.Google Scholar
  31. VanLandingham, M., Knodel, J., Im-em, W., & Saengtienchai, C. (2000). The impacts of HIV/AIDS on older populations in developing countries: some observations based upon the Thai case. Journal of Family Issues, 21(6), 777–805.CrossRefGoogle Scholar
  32. VanLandingham, M., Im-em, W., & Saengtienchai, C. (2005). Community reaction to persons with HIV/AIDS and their parents in Thailand. Journal of Health and Social Behavior, 46(4), 392–410.CrossRefGoogle Scholar
  33. Vithayachockittikhun, N. (2006). Family Caregiving of persons living with HIV/AIDS in Thailand: caregiver burden, an outcome measure. International Journal of Nursing Practice, 12, 123–128.CrossRefGoogle Scholar
  34. Wolfe, W. R., Weiser, S. D., Leiter, K., Steward, W. T., Korte, Fiona Percy-de, Phaladze, N., et al. (2008). The impact of universal access to antiretroviral therapy on HIV stigma in Botswana. American Journal of Public Health, 98(10), 1865–1871.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Population Studies Center, Institute for Social ResearchUniversity of MichiganAnn ArborUSA

Personalised recommendations