In 1998, approximately 30 million people worldwide were living with HIV/AIDS, about 5 million of whom became infected that year. The epidemic continues to expand, with an estimated doubling time of 10 years, making AIDS the leading infectious cause of death ahead of tuberculosis and malaria. Even in the U.S.A. where the death rate from AIDS is declining as a result of effective drug therapies, HIV infection rates continue to climb in several population groups. The prevalence of AIDS among people over the age of 50 is steadily increasing, and most older people are unprepared to address it for a number of reasons, including the widespread discomfort with matters sexual and homosexual and the belief that elderly people are not sexually active and therefore not at risk. This guide for care providers seeks to educate and inform readers about the difficulties and complications that accompany the disease in older people. Thus, while the appendix includes technical descriptions of methodology, data, and results, the narratives in the chapters describing the findings and their practical implications are written in layman's language. Topics covered include biomedical aspects, demographics, sexuality, stressors, mental health, older women, and patient care, all of which are supported by case studies.


AIDS care providers, such as primary care givers, social workers, case managers, nurses, physicians, home health workers, clergy, counselors, and paraprofessionals; members of the general public such as the AARP and other groups focused on aging issues.

Table of Contents

HIV/AIDS in Middle-Aged and Older Adults: A Research Response Findings from the West Central Florida Survey of Middle-Aged and Older Adults with HIV Disease The Experience of Older Adults Living with HIV Overview of the Biomedical Aspects of HIV and Its Impact on Older Adults HIV-Related Stressors, Coping, and Social Support Mental Health and HIV Providing Services to Older Adults with HIV Disease People of Color: HIV Prevention and Treatment Issues Effects of HIV Disease on Women Older Adult Sexuality and HIV End of Life Issues HIV Prevention and Outreach In Conclusion Appendices


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© 2002
Academic Press
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About the authors

Janice Nichols

The Louis de la Plarte Florida Mental Health Institute, University of South Florida, Department of Aging and Mental Health, Tampa, Florida, U.S.A.

David Speer

David Speer (Ph.D., University of Minnesota) is an associate professor and clinical research psychologist at the Florida Mental Health Institute at the University of South Florida in Tampa. His duties include consultation, education, and training services to the public mental health system for older adults, grant writing, and clinical research. Before coming to Tampa, Dr. Speer was a Post Doctoral Fellow at the University of Notre Dame from 1986 to 1988 and was an executive director of the Northeastern Center (a CMHC) in Kendallville, Indiana from 1982 to 1986. He has also served in executive positions at the Quinco Consulting Center in Columbus, Indiana and the Erie County Suicide Prevention and Crisis Services in Buffalo, New York. He has authored or co-authored 45 journal publications and is the editor of Nonverbal Communication, Sage (1972).


"Overall, the book is written in a highly accessible and jargon-free style, and is relevant to researchers interested in issues relating to sexuality and ageing, as well as practitioners working with older people with HIV. It will also be of interest to older people living with HIV and to their friends and families." -Ageing and Society, 2004 "HIV in Middle-Aged and Older Adults: Mental Health, Health, and Social Issues is a comprehensive look into the struggles that older people with HIV face. The interviews offer an insight into the complicated struggles of a segment of the HIV population that has often been forgotten. Sex and substance use are alive and well in the older population. Providers involved with the care of older people need to have in-depth information on the impact of HIV on aging. This book is a real 'eye opener' for clinicians, care managers, and anyone who makes decisions about HIV care." Donna Gallagher, Director, New England AIDS Education and Training Center, Boston, U.S.A. "The interweaving of descriptive findings from teh 172 HIV+ subjects and the in-depth data from the 15 people living in Florida, along with a comprehensive application of the professional literature, enhances our understanding of the realities of aging and living with HIV/AIDS. This work is a 'must have' resource for providers and researchers interested in the lives of middle-aged and older people living with HIV/AIDS." Kathleen M. Nokes, CUNY, U.S.A. "In one of the first scientific book length reports of older HIV positive people, the authors sensitively reveal the vulnerability, depression, poverty and isolation of one of the fastest growing portions of the epidemic. Their attention to these often hidden people, often living in minority communities, calls upon all of us to change our thinking about older adults and develop education, service, and support