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This study assessed 29 HIV-positive adults over the age of 50 living in U.S. rural counties. Using thematic content analysis, they examined the nexus of aging and HIV to identify factors that affects overall health, engagement in care, and medication adherence These older adults were more concerned with health conditions other than HIV. Lack of concern for HIV were attributed to fewer HIV-related complications, degree of comfortability and the number of years living with HIV. People living with HIV in rural areas confronted multiple structural barriers which had a significant impact on access and engagement in care. These structural barriers include lack of patient-centered and coordinated care, lack of local providers, proximity to a healthcare facility and transportation. HIV-stigma and disclosure were factors contributing to seeking providers and pharmacies outside their communities. The study also showed that managing with multiple co-morbidities, financial burdens due to medication cost, incomplete prescription delivery, and inability to keep track of multiple medications, all posed significant challenges to medication adherence and care access.
Summary by Stephen Karpiak PhD, ACRIA and New York University College of Nursing