Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.
College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Front Public Health. 2023 Mar 13;11:1061339. doi: 10.3389/fpubh.2023.1061339. eCollection 2023.
As the global population ages and the HIV pandemic matures, a growing number of older persons aged ≥50 years are becoming increasingly vulnerable to acquiring HIV. Unfortunately, older persons are often neglected and left out of sexual health programs and services. This study explored the experiences of older persons living with and without HIV in accessing prevention and care services and how those experiences translate into the neglect and abuse of older persons. The study also explored older people's perspectives on community responses to HIV in older people.
This qualitative analysis used data from 37 individuals who participated in focus group discussions conducted in 2017/2018 across two communities in Durban, South Africa. Using an interview guide and thematic content analysis, salient themes regarding attitudes to HIV in older persons and factors of access to HIV prevention and cares services for older persons were analyzed.
The study participant's mean age was 59.6 years. Major themes emerging from the data included factors impacting HIV prevention and transmission in older people; community responses to HIV contributing to the abuse of older people, and structural drivers of abuse in older people living with HIV (OPLHIV). Knowledge about HIV and how to protect themselves from HIV was limited among participants. Older persons were frightened to acquire HIV at an older age as they feared judgment and discrimination for getting HIV at that age. OPLHIV reported frequently experiencing community stigma and poor staff attitudes and practices at health facilities, such as a triage health delivery system that fueled community stigma. Participants also experienced neglect, verbal and emotional abuse at healthcare facilities.
Although there were no reports of physical and sexual abuse of older persons in this study, this study shows that despite decades of HIV programs in the country, HIV-related stigma, discrimination, and disrespect of older persons remain pervasive in the community and at health facilities. As an increasing number of people age and live longer with HIV, the neglect and outright abuse of older persons need urgent policy and program interventions.
随着全球人口老龄化和艾滋病疫情的发展，越来越多的 50 岁及以上老年人更容易感染艾滋病。不幸的是，老年人往往被忽视和排除在性健康方案和服务之外。本研究探讨了感染和未感染艾滋病毒的老年人获得预防和护理服务的经验，以及这些经验如何转化为对老年人的忽视和虐待。本研究还探讨了老年人对社区应对老年人艾滋病问题的看法。
本定性分析使用了 2017/2018 年在南非德班两个社区进行的 37 名参与者的焦点小组讨论的数据。使用访谈指南和主题内容分析，对有关老年人对艾滋病的态度和老年人获得艾滋病毒预防和护理服务的因素等突出主题进行了分析。
研究参与者的平均年龄为 59.6 岁。数据中出现的主要主题包括影响老年人预防和传播艾滋病的因素；社区对艾滋病的反应导致对老年人的虐待，以及生活在艾滋病毒中的老年人（OPLHIV）受虐待的结构驱动因素。参与者对艾滋病的知识以及如何保护自己免受艾滋病的侵害知之甚少。老年人害怕在老年时感染艾滋病，因为他们担心在那个年龄感染艾滋病会受到评判和歧视。OPLHIV 报告经常在社区中受到污名化，以及在医疗机构中工作人员的态度和做法不佳，例如分诊保健提供系统助长了社区的污名化。参与者还在医疗机构中经历了忽视、言语和情感虐待。
尽管本研究没有报告老年人遭受身体和性虐待的情况，但本研究表明，尽管该国开展艾滋病毒方案已有几十年，但艾滋病毒相关的耻辱、歧视和对老年人的不尊重在社区和医疗机构中仍然普遍存在。随着越来越多的人年龄增长并长期携带艾滋病毒，对老年人的忽视和虐待需要紧急的政策和方案干预。
