June 5, 2008
The over-50 crowd relearns the ‘facts of life’
(Page 2 - Previous Page)Like Fowler, Shaw's mission for more than a decade has been to spread awareness of the risks of HIV in older people.
"I think that what we really need now is a bold, new vision, some real 'out-of-the-box' thinking," he said, explaining that his mission is to "tear down the wall" of barriers in communicating about HIV.
He developed what he calls the "intergenerational approach" to communicating about the virus.
"What we need to do is connect whole families to start talking about health in general," he said, explaining that young people who are more likely to talk about sensitive issues like sexually transmitted diseases and AIDS can break down the barriers to talk candidly with the "older generations."
"I think when you get different generations to all sit down together -- parents, kids, grandparents, aunts, uncles, whomever -- you can all learn from each other, and this is key to breaking down traditional taboos of discussion," Shaw said.
Diagnosed HIV positive more than two decades ago, Shaw spends a lot of time in New York's community senior centers spreading his enthusiasm and "tearing down the wall" on HIV discussions. He says his "soft-sell approach works well" -- using raffles, screenings and health fairs to promote senior attendance to his programs.
"Telling this story to older people is more than renting a space and handing out brochures," he said. "If you advertise 'come and learn about HIV in the elderly' you'll be talking to an empty room! I get people together to talk about aging and health from a wellness approach, then, we can introduce HIV as a discussion point."
Public Policy Recommendationsfor Unmet Needs
Based on the findings of the 1,000 participants of ROAH, the first study of an HIV-positive population age 50 and older, Karpiak and his colleagues have outlined policy recommendations that are needed to address the multiple social and health delivery issues of this marginalized population.
"There needs to be action on three fronts," he explained, "health care, clinical research and social policy."
The shorthand message is to educate physicians and advance an awareness of this aging population with HIV, to conduct research to learn about physiological effects and develop programs to address unmet social needs.
"We need to address the problem of stigma and conduct public education and outreach awareness that targets the general public, and to also create prevention messages that target older people," Karpiak said. "The medical community needs to realize all patients are at risk, and that those older people who have the virus need a different kind of care than someone who is in their 20s or 30s."
Karpiak calls for amendments in the Older Americans Act and its Caregiver Support Program elements.
"We'd like to see [the U.S. Department on Health and Human Services] make specific provisions in programs and services and fund the Agency on Aging to pay for education and training," he said.
The researchers also envision local AIDS service organizations as the ideal resource that can provide specialized training to Area Agencies on Aging, to home health services and to other community outreach services that may have contact with older HIV-positive people as well as their typical client population.
The ROAH team also recommends more research on the medical and health needs of older HIV-positive people, including them in clinical trials, and implementing curricula in medical and nursing schools that address the specific needs and challenges of older people with the virus.
For more information, visit the AIDS Community Research Initiative of America Web site at acria.org.
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