A Case-Controlled Study of Successful Aging in Older HIV-Infected Adults

Objective: There is a growing public health interest in the aging human immunodeficiency virus (HIV)-infected (HIV+) population, although there is a dearth of research on successful aging with HIV. This study aimed to understand the risk and protective factors associated with self-rated successful aging (SRSA) with HIV.

Design: Cross-sectional, case-controlled.

Setting: HIV Neurobehavioral Research Program and the Stein Institute for Research on Aging at University of California, San Diego.

Participants: Eighty-three community-dwelling HIV+ and 83 demographically matched HIV-uninfected (HIV−) individuals, enrolled between December 1, 2011, and May 10, 2012, mean age of 59 years, primarily white men, 69% with acquired immune deficiency syndrome (AIDS), who had been living with an HIV diagnosis for 16 years. Diagnostic criteria for HIV/AIDS were obtained through a blood analysis.

Measurements: Participants provided ratings of SRSA, the primary outcome measure, as part of a comprehensive survey that included measures of physical and emotional functioning and positive psychological traits. Relationships between how the different variables related to SRSA were explored.

Results: While SRSA was lower in the HIV+ individuals than their HIV− counterparts, 66% of adults with HIV reported scores of 5 or higher on a 10-point scale of SRSA. Despite worse physical and mental functioning and greater psychosocial stress among the HIV+ participants, the 2 groups had comparable levels of optimism, personal mastery, and social support. Higher SRSA in HIV+ individuals was associated with better physical and emotional functioning and positive psychological factors, but not HIV disease status or negative life events.

Conclusions: Successful psychosocial aging is possible in older HIV+ individuals. Positive psychological traits such as resilience, optimism, and sense of personal mastery have stronger relationship with SRSA than duration or severity of HIV disease. Research on interventions to enhance these positive traits in HIV+ adults is warranted.

J Clin Psychiatry 2013;74(5):e417-e423

© Copyright 2013 Physicians Postgraduate Press, Inc.

Submitted: August 14, 2012; accepted December 11, 2012 (doi:10.4088/JCP.12m08100).

Corresponding author: Dilip V. Jeste, MD, 9500 Gilman Drive #00664, La Jolla, California, 92093 ([email protected]).