HIV/AIDS and Aging: Exploring Canadian Responses

Transcription

1 HIV/AIDS and Aging: Exploring Canadian Responses Charles Furlotte McMaster University Ron Rosenes Canadian Treatment Action Council (CTAC) Le-Ann Dolan & Larry Baxter Canadian Working Group on HIV and Rehabilitation (CWGHR)

2 HIV and Complex Aging Functional vs. chronological age Premature aging? (Deeks & Phillips, 2009) Accelerated disease progression (Adler et al., 1997; Kohli, 2006; Manfredi, 2004;) Complications of HIV and its treatment with meds People who are younger could also be considered older Multiple markers, including: bone density, cognition, or immune function Defining late-life both by age and length of infection?

3 HIV, and the Politics of 50+ Practices of Centre for Disease Control (U.S.) and Public Health Agency of Canada: 50+ Focus on the sixth decade of life: fails to address older PHAs living in their 60s, 70s and 80s, and the many age differences between young-older and old-older adults; Obscures visibility of long term survivors who are not yet 50, but approaching this milestone; Presents barriers to integrating HIV into conventional research about aging Use of 50 and over to signal older adulthood is just not typical of mainstream aging research, which traditionally defines old age as occurring much later, far beyond 50. As such, conventional gerontology and geriatric professionals may lack complete knowledge of HIV and aging. Aging sector may come to exclude PHAs who are only in their fifties, citing that they are not old enough to capture the attention of aging specialists.

4 Illness, Disability & Episodicity Politics of language HIV as a complex chronic illness HIV now referred to as an episodic disability Not disabled enough (Lightman, 2009) Employment and return to work Largely influenced by rehabilitation sciences (O Brien et al, 2009; Solomon et al, 2011 )

5 Complex Chronicity & Analogous Conditions Complexity & chronic illness (Charmaz, 1990) Cross-condition approach Analogous illnesses- HIV, multiple sclerosis, lupus, Parkinson s disease, Alzheimer s disease, arthritis, diabetes & some forms of cancer Tensions - Downgrading and the future of HIV exceptionality (Bayer, 1999)

6 HIV & Aging: The Research Enterprise U.S. Precursors social work professor Michael Maclean and gerontologist Chris Claap published the first Canadian articles on HIV/AIDS and aging in Geriatrics Today and Canadian Social Work Review. 2005, - Tara Fritsch conducted a landmark study comparing older and younger PHAs on service utilization. Since then, considerable increase in work dedicated to HIV and aging in Canada (Brennan, Emlet & Eady, 2011; Furlotte et al, 2012; Solomon, 2011; Wallach, 2011). Increased representation at research conferences- Ontario HIV Treatment Network (OHTN) and Canadian Association on HIV Research (CAHR) and Canadian Association on Gerontology (CAG).

7 Governmental Responses The Public Health Agency of Canada (PHAC) has been reporting analyses of surveillance data of 50+ PHAs since 2004 (EpiReports series) HIV and aging is represented in priority calls for research funding at the Canadian Institutes of Health Research (CIHR) CIHR introduced a directed stream of funding for knowledge creation on HIV and related comorbidities (CIHR, 2012). CIHR-sponsored research cafes that focus on aging and HIV PHAC funding for capacity building, knowledge translation and exchange New research teams are emerging

8 Policy and Non-governmental Organizations HIV and aging now reflected in portfolios at several AIDS service organizations Canadian AIDS Treatment and Information Exchange (CAITE)- E-brochure; Canadian Treatment Action Council (CTAC); Canadian AIDS Society (CAS) - Backgrounders Much of the development of the in HIV and aging movement credited to the Canadian Working Group on HIV and Rehabilitation (CWGHR)

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10 Frontline Responses 2010s: HIV and aging at several AGMs, community health forums, learning exchanges- Pacific AIDS Network, Positive Living Society of BC; The AIDS Network- southern ON, AIDS Committee of Ottawa Casey House- programming that will include day hospitals geared to older PHAs AIDS Committee of Toronto programming Changes taking place to better situate aging as a topic covered by service providers

11 Co-ordinated National Responses Partners in Aging National Forum (Montreal, 2010) formation of the first Partners in Aging National Coordinating Committee Today- National HIV and Aging Committee- Research, Clinical and Programs and Services working groups CAG-ASEM (2011) : Learning across Borders: HIV and Complex Chronic Illnesses as We Age Pre-Conference Workshop

12 Implications Canadian responses are collaborative across geography and sectors and influenced by community members, governmental reporting and funding and largely taken up by the HIV and rehabilitation sector. Lenses of episodic disability and complex chronicity have emerged in Canadian responses to HIV and aging

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14 Thank- you Charles Furlotte, MSW, RSW PhD Student School of Social Work McMaster U furlotcr@mcmaster