Awareness and Knowledge on Aging and HIV-Associated Neurocognitive Disorder: Service User and Provider Perspectives in Southern Nevada

HIV-Associated Neurocognitive Disorder (HAND) is a condition that can affect up to 50% of people living with HIV/AIDS (PLWH) and present as a cluster of neurocognitive difficulties in domains such as attention, memory, concentration, language, information processing, decision-making, problem-solving, and even motor skills. The current study intended to identify awareness and knowledge of HAND among middle-aged and older PLWH and their healthcare or service providers in Southern Nevada. Using a Community-Based Participatory Research approach, participants from the community were recruited to complete a survey that assessed awareness and knowledge of HAND. The survey also assessed the personal experiences of PLWH related to neurocognitive difficulties, as well as the work experiences of healthcare and service providers related to their patients’ or clients’ neurocognitive issues. In this thesis, the findings, descriptive statistics, and discourse reveal the current levels of awareness of HAND in Southern Nevada, as well as examine the demographic variables that are associated with knowledge of HAND in the community. The lessons learned discussed in this thesis underscore the need to raise awareness and knowledge of HAND among relevant community stakeholders so that individuals, programs, and services can be better prepared to identify and address HAND as the need arises

Pandemic upon Pandemic: Middle-Aged and Older Men Who Have Sex with Men Living with HIV Coping and Thriving during the Peak of COVID-19

When the COVID-19 pandemic emerged in early 2020, not only did it abruptly impede the progress that was being made toward achieving global targets to end the HIV pandemic, but it also created significant impacts on the physical and mental health of middle-aged and older men who have sex with men living with HIV. Utilizing a qualitative, community-based participatory research approach, we conducted semi-structured, one-on-one interviews with 16 ethnoracially diverse, middle-aged and older men who have sex with men living with HIV residing in Southern Nevada, to examine the different ways the COVID-19 pandemic directly impacted their physical and mental health, and explore how they eventually coped and thrived during the peak of the crisis. Using thematic analysis to analyze our interview data, we identified three prominent themes: (1) challenges to obtaining credible health information, (2) the physical and mental health impacts of the COVID-19-pandemic-imposed social isolation, and (3) digital technologies and online connections for medical and social purposes. In this article, we extensively discuss these themes, the current discourse on these themes in academic literature, and how the perspectives, input, and lived experiences of our participants during the peak of the COVID-19 pandemic could be critical to addressing issues they had already been experiencing prior to the emergence of the pandemic in 2020, and just as importantly, helping us best prepare in stark anticipation of the next potentially devastating pandemic

The Resilience of Middle-Aged and Older Men Who Have Sex with Men to HIV/AIDS: Southern Nevada Stakeholder Perspectives in the 21st Century

This community report presents the findings and analysis of a survey that was part of the quantitative stage of a mixed-method Community-Based Participatory Research (CBPR) project dedicated to examine the perspectives and lived experiences of racially and ethnically diverse, middle-aged and older men who have sex with men in Southern Nevada on factors that build and promote their resilience to HIV/AIDS. The CBPR project was conducted in collaboration with community partners such as the LGBTQIA+ Community Center of Southern Nevada, Southern Nevada Health District’s Ryan White Program, Community Counseling Center of Southern Nevada, and numerous other agencies from Clark County and surrounding areas. The findings and analysis of the survey were meant not only to inform and influence the subsequent qualitative stage of the CBPR project, but also services and programs in Southern Nevada that have a focus on promoting the resilience of men who have sex with men to HIV/AIDS

Awareness and Knowledge of Aging and HIV-Associated Neurocognitive Disorder: Service User and Provider Perspectives and Experiences in Southern Nevada

This community report presents the findings and analysis of a survey that was part of the quantitative stage of a mixed-method Community-Based Participatory Research (CBPR) project dedicated to examine the awareness and knowledge of racially and ethnically diverse, middle-aged and older people living with HIV/AIDS, and their healthcare and service providers from Southern Nevada, on aging, brain health, HIV/AIDS, and the condition known as HIV-Associated Neurocognitive Disorder. The CBPR project was conducted in collaboration with community partners such as the LGBTQIA+ Community Center of Southern Nevada, Southern Nevada Health District’s Ryan White Program, Community Counseling Center of Southern Nevada, and numerous other agencies from Clark County and surrounding areas. The findings and analysis of the survey were meant not only to inform and influence the subsequent qualitative stage of the CBPR project, but also services and programs in Southern Nevada that have a focus on supporting the brain health and cognitive needs of aging people living with HIV/AIDS

Mitigating Risks and Building Resilience to HIV/AIDS: Perspectives of HIV-Negative, Middle-Aged and Older Men Who Have Sex with Men

Purpose: Although ample research has been conducted on resilience to HIV/AIDS, most studies have utilized quantitative methods and focused almost exclusively on people living with HIV/AIDS. A relatively untapped source of knowledge is the perspectives of HIV-negative, middle-aged and older men who have sex with men (MSM) who have been navigating risks and building resilience to HIV/AIDS since the 1980s. Our qualitative, community-based participatory research study examined the perspectives of HIV-negative, middle-aged and older MSM on factors that helped mitigate the risks of and build resilience to HIV/AIDS. Methods: In collaboration with community-based organizations, fourteen participants were recruited for in-depth interviews. Participants were aged 40 or older, identified as HIV-negative MSM, and resided in Ontario, Canada. Thematic analysis of interviews revealed salient themes. Results: Three themes were identified: (1) individual attributes (e.g., self-awareness/control), (2) protective relational factors (e.g., meaningful sexual relationships), and (3) community-based resources (e.g., competent healthcare/service providers). Conclusion: HIV-negative, middle-aged and older MSM recognized factors that helped mitigate risks of contracting and build resilience to HIV/AIDS based on their own lived experiences. Some of these factors have not been explicitly identified or extensively discussed in extant academic literature, and are worth considering in the development of community-based HIV/AIDS prevention and intervention programs

Barriers and Facilitators to Promoting Resilience to HIV/AIDS: A Qualitative Study on the Lived Experiences of HIV-Positive, Racial and Ethnic Minority, Middle-Aged and Older Men Who Have Sex with Men from Ontario, Canada

Evidence-based research has highlighted the need for exploring factors that support the mental health of men who have sex with men living with HIV/AIDS (MSMLWH), and environmental influences that promote their resilience to HIV/AIDS. This exploratory study utilized a community-based participatory research approach to investigate barriers and facilitators to promoting resilience to HIV/AIDS, specifically among racial and ethnic minority, middle-aged and older MSMLWH, a population that continues to be significantly impacted by HIV/AIDS today. This collaborative, qualitative study recruited participants who identified as racial or ethnic minority MSMLWH, were aged 40 or older, and resided in Ontario, Canada. Participants (n = 24) discussed in their interviews barriers and facilitators to promoting resilience to HIV/AIDS, which they recognized from their lived experiences. Utilizing thematic analysis, themes related to barriers and facilitators to promoting resilience to HIV/AIDS were identified. Themes related to identified barriers included: (1) language proficiency, (2) racism, (3) pernicious norms in North American gay culture, and (4) HIV stigma. Themes related to identified facilitators included: (1) compartmentalization, (2) perseverance, and (3) community-based health and social services. This article discusses the implications of the study’s findings, particularly on how they may influence the development of future services for racial and ethnic minority, middle-aged and older MSMLWH

Protective Factors That Foster Resilience to HIV/AIDS: Insights and Lived Experiences of Older Gay, Bisexual, and Other Men Who Have Sex with Men

Since the beginning of the HIV/AIDS epidemic, gay, bisexual, and other men who have sex with men (gbMSM) have been disproportionately impacted by HIV/AIDS health disparities. Research showed that resilience to HIV/AIDS is associated with increased use of relevant health services, lower sexual health risks, and improved mental health outcomes among racially and ethnically diverse gbMSM. As the subpopulation that has historically been impacted by HIV/AIDS the longest, older gbMSM living with HIV/AIDS have inarguably exhibited resilience to HIV/AIDS the most. The qualitative study described in this paper sought to identify and examine protective factors that fostered resilience to HIV/AIDS based on the insights and lived experiences of racially and ethnically diverse, older gbMSM. Applying a community-based participatory research approach that included the meaningful involvement of older gbMSM living with HIV/AIDS in different roles (i.e., advisory committee member, collaborator, peer researcher, and participant), the study recruited and included forty-one older gbMSM living with HIV/AIDS from Ontario, Canada, in confidential, semi-structured interviews. Utilizing thematic analysis, we identified three major themes from the participant interviews as factors that fostered the resilience of older gbMSM to HIV/AIDS and helped to address HIV/AIDS health disparities: (1) established protective factors, (2) behavioral protective factors, and (3) controversial protective factors. This paper argues for the importance of valuing and capitalizing on these protective factors in the conceptualization and development of interventions, services, and programs that are dedicated to fostering resilience to HIV/AIDS

Mitigating risks and building resilience to HIV/AIDS: Perspectives of HIV-negative, middle-aged and older men who have sex with men

Purpose: Although ample research has been conducted on resilience to HIV/AIDS, most studies have utilized quantitative methods and focused almost exclusively on people living with HIV/AIDS. A relatively untapped source of knowledge is the perspectives of HIV-negative, middle-aged and older men who have sex with men (MSM) who have been navigating risks and building resilience to HIV/AIDS since the 1980s. Our qualitative, community-based participatory research study examined the perspectives of HIV-negative, middle-aged and older MSM on factors that helped mitigate the risks of and build resilience to HIV/AIDS. Methods: In collaboration with community-based organizations, fourteen participants were recruited for in-depth interviews. Participants were aged 40 or older, identified as HIV-negative MSM, and resided in Ontario, Canada. Thematic analysis of interviews revealed salient themes. Results: Three themes were identified: (1) individual attributes (e.g., self-awareness/control), (2) protective relational factors (e.g., meaningful sexual relationships), and (3) community-based resources (e.g., competent healthcare/service providers). Conclusion: HIV-negative, middle-aged and older MSM recognized factors that helped mitigate risks of contracting and build resilience to HIV/AIDS based on their own lived experiences. Some of these factors have not been explicitly identified or extensively discussed in extant academic literature, and are worth considering in the development of community-based HIV/AIDS prevention and intervention programs