A study looking specifically at the needs of LGBT people living with HIV who are 50 years of age and older in the San Francisco area has found that many of the respondents are isolated and lack a support network.
The "HIV and Aging – A Survey in Three San Francisco Area Counties" report comes as a new study on LGBT adults age 65 and older commissioned by the San Francisco LGBT Aging Policy Task Force sheds light on the needs and issues this segment of the community, until now often overlooked, grapples with on a daily basis. [See related story.]
Conducted for the HIV Health Services Planning Council, which covers San Francisco, San Mateo, and Marin counties, the HIV and aging survey included 160 participants ranging in age from 50 to 76 years old.
Recruited from social service agencies in all three counties, the respondents completed a 45-page written questionnaire. The majority, 117, lived in San Francisco; 31 resided in San Mateo; and 12 were from Marin.
Loren Meissner, 60, who is HIV-positive, conducted the research as part of his master's project at San Francisco State University. While demographers estimate that half of the people in San Francisco with an HIV diagnosis are over the age of 50, few studies have looked at older HIV-positive people in the city.
"A lot of people seem to want to tell their story. They were writing marginal comments on the survey," said Meissner, a gerontology graduate student.
One of the most striking findings was the significant number of survey respondents who said they were not "emotionally close to" or had their physical and emotional needs supported by their families, particularly those in the 50-to-55 age range.
"Most participants were relying on informal friend networks and agencies," concluded Meissner. "Almost 10 percent of those who said they required regular assistance because of HIV or other illness, disability, or frailty now or in the past, reported that they had no one to provide such care."
Most said they relied on friends (26 percent), with an equal number (14.5 percent) either turning to their partner or a paid helper for support. About 7 percent had a volunteer to help them. Another 6.6 percent said they had family to help them, while 6.6 percent relied on neighbors.
"It shows the isolation faced in this age range, which is particularly troubling because it is a rapidly graying population," said Mark Molnar, a former co-chair of the San Francisco EMA HIV Health Services Planning Council who currently serves as the council's director. "This is a community that is very challenged in getting support and supporting each other."
Because of where he recruited participants, Meissner noted that most had low to moderate incomes. The majority reported having access to HIV medications, with 91 percent currently taking HIV medicine. Only 16 percent said their HIV viral load was detectable.
Eighty percent were men, 11 percent women, and 8 percent identified as transgender women. The overwhelming majority, 93 percent, had been living with HIV for a decade or longer and 61 percent said they live alone. Less than 43 percent said they were currently in a relationship, with men and transgender people most likely to be single.
Sixteen percent were Latino, 25 percent were African American, and 54 percent were Caucasian. Asian Americans accounted for 3 percent, Native Americans made up 6 percent, and 9 percent listed they were multi-racial.
Some of the barriers to care that survey respondents indicated they face included having to pay for services (39 percent); unsure of where to access services (37 percent); the cost of services (34 percent); or they didn't know services existed (33 percent).
Recruited at six local agencies offering services, many respondents had negative views of social service providers or the process they must go through to access programs. Thirty-one percent had complaints about both red tape and service wait times; 23 percent found staff unhelpful; and 23 percent said the providers didn't like them.
As for medical services most often used, 48 percent said dental and 33 percent sought out case management. Tied in third was mental health and emergency room visits (31 percent) with hospital outpatient next (25 percent). The least used services, at 5 percent, were recovery for drugs and alcohol or hospice care.
"When we do needs assessments with any group, dental is the number one service category that is seen as needed," said Molnar. "That is not a surprise to us."
Meissner presented his study findings to the HIV planning council in late June. The oversight body is expected to refer to it as it determines what services should be prioritized for federal HIV funding resources.
"In my role as a researcher, I felt uncomfortable making conclusions and recommendations on what should be funded. I will leave that for the council to decide," said Meissner.