Enjeux: VIH

L{’}article interroge l{’}activité sexuelle des seniors vivant avec le VIH ainsi que son contexte conjugal et social. L{’}activité sexuelle des seniors séropositifs est l{’}une des préoccupations suscitées par le rapide vieillissement de la population séropositive. Elle est considérée comme l{’}une des dimensions de bien-être et d{’}intégration sociale. Plus ou moins étroitement liée à la conjugalité, elle renseigne également sur l{’}éventuelle prise en charge des seniors séropositifs quand le besoin se fera sentir. Une enquête a été menée auprès de 125 séropo- sitifs suivis dans les hôpitaux du COREVIH Vallée du Rhône (co-financeur de l{’}enquête), dont 80 par questionnaire et 45 par entretien approfondi. Au total, 80 seniors (50 ans et plus) ont été étudiés et comparés à 45 séropositifs plus jeunes. L{’}échantillon est constitué de fa ̧con aléatoire selon les rendez-vous à l{’}hôpital, mais le taux de refus est trop élevé pour considé- rer l{’}échantillon comme représentatif. Il a permis néanmoins de décrire une grande variété de situations et de repérer des régularités à l{’}intérieur des différentes catégories de seniors séropositifs. Ainsi, hommes et femmes hétérosexuels, HSH et bisexuels constituent quatre confi- gurations contrastées. Les hommes hétérosexuels ont tendance à continuer de vivre dans leur environnement familial (femme, enfants, parfois petits-enfants), mais sur un mode conflic- tuel et sans activité sexuelle. Les femmes hétérosexuelles vivent souvent seules {—} comme au moment de leur contamination {—} mais en bons termes avec leurs enfants. Les HSH vivent le plus souvent en couple séroconcordant, couple post-dépistage, affectif, harmonieux, mais peu sexuel. Les hommes bisexuels, enfin, vivent souvent seuls, sans activité sexuelle, en situation conflictuelle avec enfants et ex-compagnes. Ils semblent les plus isolés socialement et les plus fragiles psychologiquement.

Little is known about abuse experienced among African American men who have sex with men (MSM) who are 50 years and older. A series of focus groups were conducted to examine perspectives of seropositive African American MSM age 50 years and older who reported experiencing some form of psychological or physical abuse. Thirty African American MSM were divided into four focus groups and four themes emerged: {\textquotedblleft}Fear Being Gay,{\textquotedblright} {\textquotedblleft}No One Else to Love Me,{\textquotedblright} {\textquotedblleft}Nowhere to Turn,{\textquotedblright} and {\textquotedblleft}Sexual Risk {&} Control.{\textquotedblright} The data suggest there is a need to develop culturally tailored interventions for this population.

This study examined mental and physical health, per- ceived social support, and experiences with HIV/AIDS of 416 lesbian, gay, and bisexual adults aged 60 to 91. Most participants reported fairly high levels of self-esteem; however, many experienced loneliness. Most also reported low levels of internalized homophobia, but men reported significantly higher levels than women did. Ten percent of respondents sometimes or often considered suicide, with men reporting significantly more suicidal thoughts related to their sexual orientation. Men also had significantly higher drinking scores than women, and more men could be classified as problem drinkers. Only 11% of the respondents said that their health status interfered with the things they wanted to do. Although 93% of the participants knew people diagnosed with HIV/AIDS, 90% said that they were unlikely to be HIV-infected. Participants averaged six people in their support networks, most of whom were close friends. Most support network members knew about the participants{’} sexual ori- entation, and the respondents were more satisfied with support from those who knew. Those living with domestic partners were less lonely and rated their physical and mental health more positively than those living alone

Since the introduction of highly active antiretroviral therapy, people living with HIV/AIDS (PLWHA) are living longer, into older age, and therefore presenting a host of new challenges for health and social service providers. However, not all PLWHA are likely to experience similar transitions into older age. In particular, research has yet to fully investigate the health and psychosocial well-being of older HIV-positive gay men. Drawing from an Australian population-based sample of 693 HIV-positive gay men, the present study assesses the overall health and well-being of this older group compared to their younger counterparts. While older men reported greater comorbidity and were more likely to be living in poverty, other health and well-being indicators suggest this group to be coping comparatively well as they continue to age with HIV. These findings provide new directions for meeting the present and future needs and challenges of older HIV-positive gay men.

European Geriatric Medecine, 8 (2017) 66-70. doi:10.1016/j.eurger.2016.12.003

Human immunodeficiency virus (HIV) was once thought of as a condition predominately affecting the young. However, HIV among the older population is increasing. Older gay male adults living with HIV have received little attention from those who provide and commission services. However, with effective treatment, those gay men aged over 50 are the fastest growing group of people with HIV in the UK. Nurses will be required to offer care in a number of ways to this cohort of patients. In so doing, nurses will need to develop innovative and effective ways of supporting this growing group of people. This article provides an overview of the issues that can impact on the health and wellbeing of the older gay man living with HIV. The article discusses the epidemiology, the issue of HIV stigma, comorbidities and mental health and wellbeing needs.

L{’}infection VIH est en voie de devenir une maladie chronique, suite à la baisse de la mortalité induite par l{’}introduction des traitements antiviraux co…