Gaps in health and social care services to older adults living with HIV: a qualitative study on the perspectives of older adults and service providers

Abstract

Medical and social science research on older adults living with HIV (OAHIV) has shed light on the significant health needs and the many psychosocial difficulties experienced by this population. Despite the obvious need for health and social care services among OAHIV, few studies have addressed their experiences with regard to these resources. This study attempts to identify the challenges, difficulties and gaps found within social and health services intended for those located at the intersection of HIV and aging. Using a qualitative methodology, this study explores the perspectives of both older adults living with HIV (OAHIV) and their healthcare providers in order to document gaps in service delivery. Semi-structured interviews were conducted with 50 participants, including 38 OAHIV and 12 healthcare providers working with this population. Analysis was undertaken to identify themes related to challenges at individual and structural levels of practice. Several challenges were identified including; a) within the individual healthcare encounter with HIV specialists, b) accessing non-HIV related health services, and c) a lack of psychosocial resources, HIV community resources and residential resources addressing the intersection of HIV and aging. Interpreting our results through the theoretical lens of intersectionality helped identify transversal problems associated with the intersection of HIV and aging including inadequacy of resources and discrimination. Recommendations for changes to policy and practice are highlighted.