Too old to test? Prevalence and correlates of HIV testing among sexually active older adults

ABSTRACT

Older adults account for 17% of new HIV diagnoses in the US and are more likely to be diagnosed with HIV later in the course of the disease compared to younger people. We calculated the prevalence and associated factors of having ever been tested for HIV among sexually active older adults. We analyzed data from the 2008–2016 General Social Survey Limited to respondents ≥65 years of age who reported more than one sex partner(s) in past 12 months (n = 757). HIV testing prevalence, prevalence ratios, and 95% confidence intervals were calculated by demographic variables and HIV-related risk behaviors. An estimated 16.3% of sexually active older adults have tested for HIV, and 15.9% were at increased risk for HIV infection (reported injection drug and/or crack–cocaine use, exchanging money for sex, more than three sex partners in the past year, or men who reported having sex with another man). In the adjusted model, adults aged 65–70, not married, self-identified as gay/bisexual, and at increased risk for HIV infection were more likely to have tested for HIV. An estimated 83.7% of sexually active older adults never tested for HIV. Strategies are needed to increase HIV awareness and testing among potentially high-risk older adults.     

Centrelink: how social workers make a difference for young persons. A model of intervention

It is mandatory for social workers at Centrelink to interview and assess under 18-year-old youth who are applying for the ‘Unreasonable to Live at Home’ (UTLAH) rate of Youth Allowance. The aims of this research project were to identify and describe social work models of intervention when interviewing young persons who applied for UTLAH payments and to examine the way in which social workers developed a response to organisational and legislative changes. The qualitative research consisted of two components: field observations of social work interviews with claimants and an open-ended questionnaire completed by social workers after the observed interaction. The research confirmed the hypothesis that parts of a number of social work interventions could be combined and used to effectively assess and assist clients within the prescribed short-term approach. In addition, it supported the researchers' belief that social work models of intervention could be adapted to organisational and environmental changes. A potential challenge for social workers at Centrelink is to produce a brief social work model of intervention that is flexible enought to be used by professionals across sectors.     

A Qualitative Exploration of Self-Regulation Behaviors Among Older Drivers

While much of the research on aging and driving has focused on sensory and motor changes, little is known about older drivers and the actual self-regulation adjustments they employ to continue driving safely. This research looks at how older drivers have made changes to driving patterns and behaviors that have allowed them to continue to drive without compromising their perceived safety, independence, and quality of life. Nine focus groups were held with older men and women aged 58 to 89 years. Some of the major themes that emerged were the following: older adults are very aware of age-related changes to driving; they perceive that self-regulation behaviors change with age; and they view transportation alternatives as limited or nonexistent. Policy implications include developing functional transit programs for older adults and car manufacturer training workshops to educate older adults on the safety features of newly purchased automobiles.     

Anxiety and Depression: Implications for Older Adults

By the year 2030, it is projected that one in every three Americans will be 55-years-old or older. This age group is by far thefastest growing segment of the population. With the growing number of older adults, the importance of understanding aging and common disorders of laterlife is essential. In particular, anxiety anddepression are among the most common problems in older adults. However, differentiating anxiety and depression at the mood, symptom, and syndromal levels has been a long-standing problem in psychopathology research. In addition to a growing need for research, clinicians will also need to take an active role in the development and implementation of treatment as the population of older adults increases. In particular, mental health service providers must become informed about the economic implications for older adults as the structure of health insurance continues to change.     

Lesbian and gay men’s perceptions of their local area agency on aging

This article reviews data from a qualitative study of lesbians and gay men about engagement with their local Area Agency on Aging (AAA). Findings include lack of knowledge about the local AAA, feelings of exclusion, and the need for better outreach. It is important that AAAs engage their local lesbian, gay, bisexual, and transgender (LGBT) elders, as data show they are at higher risk for aging alone and can often harbor mistrust of formal services due to lifetimes of discrimination. Suggestions on where AAAs can find training and resources on reaching out to the LGBT older adult community and implications for the profession of social work are provided.     

Fictions and Facts about Parents and Parenting Older First-Time Entrants to Foster Care

Knowledge about the parents of older first-time entrants into foster care is embedded in fictions created by media images, anecdotal stories of professionals in the child welfare system, as well as reports and observations of youths who have experienced foster care. Even though there are caring and effective nonrelatives who are foster parents, the public perception of non-relative foster parents is sometimes quite negative. In order to separate some of the facts from some of the fictions about the parents/caregivers of older first-time entrants to foster care, this article will describe the parents and relative caregivers (grandparents and others) of older first-time entrants to foster care in an urban public welfare agency by examining maltreatment data.     

Using photography to understand change and continuity in the history of residential care for older people

The Last Refuge by Peter Townsend is a seminal study of residential care for older people. The fieldwork was carried out in the late 1950s and the data are now deposited in the National Social Policy and Social Change Archive at the University of Essex. We have undertaken research, funded by the ESRC, which has revisited Townsend's work and some of the homes he studied in order to conduct an overtime comparison. In this paper we focus on Townsend's use of photography and our subsequent use of photography in our revisiting study. We argue that although Townsend did not analyse his photographs, they were significant data for use in his arguments critiquing residential care. They were, however, the product of a different socio‐historical context to our own and as such posed considerable practical and ethical challenges for us when attempting to use this aspect of his methodology for an overtime comparison. We argue that despite the resulting constraints, photography was an important part of our methodology, enabling comparisons and illuminating historical patterns in residential care for older people.     

The case for critical social gerontology in social work education and older women1

This article argues the case for the application of critical social gerontological theory and research to social work education and older women, both as a way of heightening student social workers' awareness and understanding of the complex and diverse experiences of older women who make use of personal social services AND to develop anti‐ageist and anti‐sexist practice. In presenting this ‘case for social gerontology’, the paper will draw on findings from the author's recent research with older widows.     

‘Hearing the Real Stories about the Issues at Hand’: Politically Active Elders Engage Bachelor in Social Work (BSW) Students in Influencing Social Policy

This article focuses on the successes and challenges experienced by a social work program offering experiential learning opportunities to bachelor in social work (BSW) students. As part of the BSW Experiential Learning (BEL) Program, policy students collaborated with politically active older adults to develop compelling letters to the editor of a newspaper and influential letters to state-level legislators concerning policies impacting older adults. Using a two-year quasi-experimental design, one section of the course paired students with older adults while the other section served as the control group. Although no significant differences were found in influencing student interest in working with older adults, students paired with older adults showed greater confidence in and learning of the content. Lessons learned from this experience and implications for future implementation will be detailed.