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BMC Public Health. 2012; 12: 259.
Published online Apr 2, 2012. doi:  10.1186/1471-2458-12-259
PMCID: PMC3424116
An investigation of factors associated with the health and well-being of HIV-infected or HIV-affected older people in rural South Africa
Makandwe Nyirenda,corresponding author1,2 Somnath Chatterji,3 Jane Falkingham,2 Portia Mutevedzi,1 Victoria Hosegood,2,1 Maria Evandrou,2 Paul Kowal,3 and Marie-Louise Newell1,4
1Africa Centre for Health and Population Studies, University of KwaZulu-Natal, PO Box 198 , R618 Enroute Somkhele, Mtubatuba, 3935, South Africa
2School of Social Sciences, University of Southampton, Highfield, Southampton, UK
3Multi-Country Studies Unit, World Health Organization, Geneva, Switzerland
4Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK
corresponding authorCorresponding author.
Makandwe Nyirenda: mnyirenda/at/africacentre.ac.za; Somnath Chatterji: chatterjis/at/who.int; Jane Falkingham: J.C.Falkingham/at/soton.ac.uk; Portia Mutevedzi: pmutevedzi/at/africacentre.ac.za; Victoria Hosegood: v.hosegood/at/soton.ac.uk; Maria Evandrou: maria.evandrou/at/soton.ac.uk; Paul Kowal: kowalp/at/who.int; Marie-Louise Newell: mnewell/at/africacentre.ac.za
Received September 23, 2011; Accepted April 2, 2012.
Abstract
Background
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.
Methods
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.
Results
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.
Discussion and conclusions
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.
Keywords: South Africa, Older people, Health status, Functional ability, Quality of life
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