ATHENS, Ohio – The number of older Americans living with HIV/AIDS is growing, but many lack access to services that would help them cope with the challenges of the disease: depression, thoughts of suicide, lack of access to health care and difficulty sticking to HIV treatments.
Research by Ohio University health psychologist Timothy Heckman suggests that mental health interventions can improve the quality of life for these individuals. The National Institutes of Health recently awarded him a $1.87 million grant to evaluate the effectiveness of a face-to-face support group. The three-year study will enroll 300 adults in Columbus, Ohio, and New York City who are dealing with depression.
More than 90,000 adults with HIV/AIDS were age 50 or older at the time of their diagnosis. They are sometimes diagnosed at a later stage of the disease, Heckman said, as physicians may initially attribute symptoms to other, age-related ailments. These individuals have a dual challenge: They must cope with HIV/AIDS while adjusting to other major lifestyle changes – such as loss of career and other health problems – that come with getting older.
Heckman hopes that his proposed intervention can address their unique needs. Participants in his new study will be assigned to three different therapies. The first group will participate in a 12-session, face-to-face Coping Improvement Group Intervention tailored to the problems of older adults with HIV. The second set will participate in a discussion group on contemporary issues related to living with the disease, but will not address stress or coping mechanisms. A control group will receive no active treatment but will be assigned to brief and limited individual therapy on request.
A psychologist or social worker with experience in AIDS or mental health issues will lead the support groups, which will include six to eight participants each, said Heckman, an associate professor of health psychology. Monica Silverthorn, a social worker who serves as project coordinator of the new initiative, is working with the Columbus AIDS Task Force and Yale University to recruit clients in their respective regions for the study.
Heckman designed the Coping Improvement Group Intervention based on his previous studies of the mental health needs of older Americans with HIV/AIDS, which found that losing friends and family to AIDS or other diseases is one of the biggest stressors for them, he said. These individuals, who tend to not disclose their HIV status as readily as younger people, also may have drug interaction problems if they are taking medication for HIV and other common ailments such as arthritis or diabetes, he said.
"They spend time not only talking about living with AIDS but also about normal aging issues. They're both important," Heckman said.
The group intervention has been useful, he added, because it allows participants to share problems and coping techniques. Restricting the age of the participants to 50 and older also will make the discussion more personalized.
"We've heard from older adults that other groups may include participants who are in their 20s and 30s, and the issues that come up are not as relevant to them," Heckman said.
The researchers, who recently completed a telephone-based version of the intervention, also found that allowing the participants time alone to exchange names and contact information encouraged them to maintain a support network after the project's completion, Silverthorn said.
Heckman anticipates that the new study will show that older adults who participate in the intervention will cope with stress and depression better, have a higher quality of life and greater sources of social support and sense of satisfaction. If successful, the researcher will disseminate the program to AIDS and gerontology organizations for use with their older clients.
Other Ohio University collaborators on the study are Julie Suhr, associate professor of psychology, and Steven Clay, a physician with the university's College of Osteopathic Medicine.
Source: Eurekalert & othersLast reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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