HIV diagnosis disclosure: stigma management and stigma resistance.

This article reports diagnosis disclosure decision comments arising serendipitously in five focus group discussions with 34 HIV-infected New Yorkers over age 50. Three overarching disclosure themes demonstrate the complexity of diagnosis disclosure decision-making: (a) hiding or selectively disclosing, or stigma management; (b) partial disclosure because of the perception of partial control of the information; and (c) widespread or complete voluntary diagnosis disclosure, representing stigma resistance. Social workers and other human services practitioners should remember the diversity in the HIV population, the aging population, and the HIV-positive aging population. Experiences of HIV stigma and choices about diagnosis disclosure and stigma management or resistance are individual, reciprocal, and dynamic.

Taking care of each other.

The first decade of AIDS was defined by death and activism, the second by medicines and hope. How can we rally again to make the third decade one of successful aging?

S-adenosylmethionine (SAM-e) for the treatment of depression in people living with HIV/AIDS.

BACKGROUND: This study reports on clinical data from an 8-week open-label study of 20 HIV-seropositive individuals, diagnosed with Major Depressive Disorder (DSM-IV), who were treated with SAM-e (S-Adenosylmethionine). SAM-e may be a treatment alternative for the management of depression in a population reluctant to add another "pill" or another set of related side effects to an already complex highly active antiretroviral therapy (HAART) regimen. METHODS: The Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory (BDI) were used to assess depressive symptomatology from 1,2,4,6 and 8 weeks after initiation of treatment with SAM-e. RESULTS: Data show a significant acute reduction in depressive symptomatology, as measured by both the HAM-D and the BDI instruments. CONCLUSIONS: SAM-e has a rapid effect evident as soon as week 1 (p < .001), with progressive decreases in depression symptom rating scores throughout the 8 week study.

Networks of older New Yorkers with HIV: fragility, resilience, and transformation.

To better understand how HIV-infected older persons receive and perceive social support, the perceptions and experiences of 34 older HIV-positive persons in New York City were explored in July and August 2005 through five focus groups. The participants' network members tended to be HIV positive and the presence of so many people with HIV in their networks tended to be serendipitous. The advantages of having a HIV-positive network include being members of a caring community that provides safety, support, mentors, and inspiration, while the disadvantage is shrinkage of the network due to illness and death. These participants demonstrated that living with HIV changes one's network because people die of HIV; new friends are made when one seeks services; and HIV-positive networks replace those lost through stigma and rejection. Social service providers and policy makers in the HIV and aging networks should expand their view of "family" and not make assumptions about the networks for older persons living with HIV. Networks expand and shrink at different times and are resilient and fragile at the same time.

HIV/AIDS treatments.

Although fewer people are being diagnosed with AIDS in the U.S. and deaths continue to decline, the number of adults age 50 and older who are living with HIV/AIDS is larger than ever. It is likely that older people will continue to comprise an increasingly larger proportion of individuals diagnosed with HIV/AIDS, reflecting both the ineffective prevention efforts targeting older adults and the highly effective antiretroviral therapies that allow many people to live for significantly longer periods of time. These recent trends have created two distinct populations of older persons with HIV/AIDS: those who were infected later in life and those infected earlier and now aging with HIV disease. Aging with HIV/AIDS presents unique psychosocial challenges that may be exacerbated by the aging process. HIV-related stigma, social support and coping issues and evidence-based psychosocial interventions for older adults with HIV/AIDS are reviewed in this paper and suggestions for future research are discussed.