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，美国监狱人口的三分之一将超过50岁。与此同时，矫正的艾滋病毒患病率是普通人群的四倍，而老年人则越来越多。尽管如此，关于成功的HIV治疗依从性的障碍和促进者知之甚少，即老年囚犯从惩教术中释放出来后面对的障碍，在这些环境中释放出艾滋病毒治疗可能很容易获得并且更容易维持。拟议的研究旨在研究成年后的成年，艾滋病毒的相关性影响着艾滋病毒药物的依从性和50岁以上艾滋病毒的人的心理社会福祉，并在过去五年中已从监狱或监狱释放。 该研究的目标1是确定障碍和促进因素，以遵守特定于艾滋病毒感染的老年人的ARV，这些ARV通过对30名HIV阳性前囚犯（50岁以上）的深入访谈，他们在过去5年中有监禁史。该目标将包括探索三组的差异，自上次监禁以来，它们是按时间分层的。 AIM 2是描述这些老年囚犯的释放后体验和社会支持网络（类型，规模及其社会角色），以及这些社会心理和经济经验以及社会网络特征对应对挑战和/或加剧遵守治疗和心理社会健康的障碍的影响。 使用AIM 1和2的发现，AIM 3是通过焦点小组开发和评估一个基于社区的小组干预，以支持并增加对监禁史的HIV老年人对治疗的依从性。这项研究的影响在于它承诺提供有关释放后经历的关键信息，这可能是对艾滋病毒迅速增长但在很大程度上被遗忘的艾滋病毒hiv患者患有监禁病史的老年人的障碍和促进者。