Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
Mbarara University of Science and Technology, Mbarara, Uganda.
J Int AIDS Soc. 2022 Sep;25 Suppl 4(Suppl 4):e26000. doi: 10.1002/jia2.26000.
With improved HIV treatment availability in sub-Saharan Africa, the population of older people with HIV (PWH) is growing. In this qualitative study, we intended to understand (1) the lived experiences of ageing people in rural Uganda, with and without HIV, (2) their fears and health priorities as they grow older.
We conducted 36 semi-structured interviews with individuals with and without HIV in Mbarara, Uganda from October 2019 to February 2020. Interview guide topics included priorities in older age, physical functioning in daily activities, social functioning, HIV-related stigma and the impact of multimorbidity on health and independence. Interviews were conducted in Runyankole, transcribed, translated and inductively coded thematically by two researchers with tests for inter-coder reliability.
The respondents were purposively sampled to be evenly divided by sex and HIV serostatus. The median age of respondents was 57 (49-73). Two-thirds were married or cohabitating, 94% had biological children and 75% cited farming as their primary livelihood. Overall, PWH considered themselves as healthy or healthier than people without HIV (PWOH). PWH rarely considered their HIV status a barrier to a healthy life, but some reported a constant sense of anxiety as it relates to their long-term health. Irrespective of HIV status, nearly all respondents noted concerns about memory loss, physical pain, reductions in energy and the effect of these changes on their ability to complete physical tasks like small-scale farming, and activities of daily living important to the quality of life, such as participating in community groups. Increasing reliance on others for social, physical and financial support was also a common theme. The most prevalent health concern among participants involved the threat of non-communicable diseases and perceptions that physical functioning may diminish.
In rural Uganda, we found that PWH consider themselves to be healthy and do not anticipate a different ageing experience from PWOH. Common priorities shared by both groups included the desire for physical and financial independence, health maintenance and social support for daily functioning and social needs. Entities supporting geriatric care in Uganda would benefit from attention to concerns about functional limitations and reported needs as people age with and without HIV.
随着撒哈拉以南非洲地区可供使用的 HIV 治疗方法不断改进，HIV 感染者（PWH）中老年人群体的数量正在增长。在这项定性研究中，我们旨在了解：（1）乌干达农村地区 HIV 感染者和未感染者的生活经历；（2）他们随着年龄增长的恐惧和健康重点。
我们于 2019 年 10 月至 2020 年 2 月在乌干达姆巴拉拉进行了 36 次与 HIV 感染者和未感染者的半结构化访谈。访谈指南主题包括老年时的优先事项、日常活动中的身体功能、社会功能、与 HIV 相关的耻辱感以及多种疾病对健康和独立性的影响。访谈以卢干达语进行，由两位研究人员进行转录、翻译和主题式归纳编码，并进行了编码间可靠性测试。
受访者是根据性别和 HIV 血清状况进行有针对性的抽样，平均年龄为 57 岁（49-73 岁）。三分之二的受访者已婚或同居，94%有亲生子女，75%的人将农业作为主要生计。总体而言，PWH 认为自己比 PWOH 更健康或更健康。PWH 很少将 HIV 状况视为健康生活的障碍，但有些人报告说，由于 HIV 与长期健康有关，他们经常感到焦虑。无论 HIV 状况如何，几乎所有受访者都表示担心记忆力减退、身体疼痛、能量减少，以及这些变化对他们完成像小规模农业等身体任务以及参与社区团体等对生活质量重要的日常生活活动的能力的影响。对他人的社会、身体和经济支持的日益依赖也是一个常见的主题。参与者最普遍的健康担忧涉及非传染性疾病的威胁以及对身体功能可能下降的看法。
在乌干达农村，我们发现 PWH 认为自己健康，并且不期望与 PWOH 有不同的衰老体验。两组共同的重点包括对身体和经济独立、健康维护以及社会支持的需求，以维持日常功能和社会需求。支持乌干达老年护理的实体将受益于关注与功能限制和报告需求相关的问题，这些问题随着 HIV 感染者和未感染者年龄的增长而出现。
