Africa Centre for Health and Population Studies, University of KwaZulu-Natal, R618 Enroute Somkhele, Mtubatuba 3935, South Africa.
BMC Public Health. 2012 Apr 2;12:259. doi: 10.1186/1471-2458-12-259.
Despite the severe impact of HIV in sub-Saharan Africa, the health of older people aged 50+ is often overlooked owing to the dearth of data on the direct and indirect effects of HIV on older people's health status and well-being. The aim of this study was to examine correlates of health and well-being of HIV-infected older people relative to HIV-affected people in rural South Africa, defined as participants with an HIV-infected or death of an adult child due to HIV-related cause.
Data were collected within the Africa Centre surveillance area using instruments adapted from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE). A stratified random sample of 422 people aged 50+ participated. We compared the health correlates of HIV-infected to HIV-affected participants using ordered logistic regressions. Health status was measured using three instruments: disability index, quality of life and composite health score.
Median age of the sample was 60 years (range 50-94). Women HIV-infected (aOR 0.15, 95% confidence interval (CI) 0.08-0.29) and HIV-affected (aOR 0.20, 95% CI 0.08-0.50), were significantly less likely than men to be in good functional ability. Women's adjusted odds of being in good overall health state were similarly lower than men's; while income and household wealth status were stronger correlates of quality of life. HIV-infected participants reported better functional ability, quality of life and overall health state than HIV-affected participants.
The enhanced healthcare received as part of anti-retroviral treatment as well as the considerable resources devoted to HIV care appear to benefit the overall well-being of HIV-infected older people; whereas similar resources have not been devoted to the general health needs of HIV uninfected older people. Given increasing numbers of older people, policy and programme interventions are urgently needed to holistically meet the health and well-being needs of older people beyond the HIV-related care system.
尽管艾滋病毒在撒哈拉以南非洲地区造成了严重影响，但由于缺乏有关艾滋病毒对 50 岁以上老年人健康状况和福祉的直接和间接影响的数据，这些老年人的健康往往被忽视。本研究旨在调查感染艾滋病毒的老年人与感染艾滋病毒的人（定义为艾滋病毒感染者或因艾滋病毒相关原因导致成年子女死亡的人）的健康和福祉的相关因素。
在非洲中心监测区域内，使用世界卫生组织（世卫组织）全球老龄化和成人健康研究（SAGE）改编的工具收集数据。有 422 名 50 岁以上的人参加了分层随机抽样。我们使用有序逻辑回归比较了感染艾滋病毒的参与者和感染艾滋病毒的参与者的健康相关因素。使用三种工具衡量健康状况：残疾指数、生活质量和综合健康评分。
样本的中位数年龄为 60 岁（范围为 50-94 岁）。与男性相比，女性感染艾滋病毒（优势比 0.15，95%置信区间 0.08-0.29）和感染艾滋病毒（优势比 0.20，95%置信区间 0.08-0.50）的人更不可能具有良好的功能能力。女性整体健康状况的调整后优势比也低于男性；而收入和家庭财富状况是生活质量的更强相关因素。感染艾滋病毒的参与者报告的功能能力、生活质量和整体健康状况均优于感染艾滋病毒的参与者。
抗逆转录病毒治疗中获得的增强的医疗保健以及为艾滋病毒护理投入的大量资源似乎使感染艾滋病毒的老年人口的整体福祉受益；而类似的资源尚未用于未感染艾滋病毒的老年人口的一般健康需求。鉴于老年人口不断增加，迫切需要政策和方案干预措施，全面满足艾滋病毒相关护理系统之外的老年人的健康和福祉需求。
