An investigation of factors associated with the health and well-being of HIV-infected or HIV-affected older people in rural South Africa

BackgroundDespite the severe impact of HIV in sub-Saharan Africa, the health of older people aged 50+ is often overlooked owing to the dearth of data on the direct and indirect effects of HIV on older people's health status and well-being. The aim of this study was to examine correlates of health and well-being of HIV-infected older people relative to HIV-affected people in rural South Africa, defined as participants with an HIV-infected or death of an adult child due to HIV-related cause. MethodsData were collected within the Africa Centre surveillance area using instruments adapted from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE). A stratified random sample of 422 people aged 50+ participated. We compared the health correlates of HIV-infected to HIV-affected participants using ordered logistic regressions. Health status was measured using three instruments: disability index, quality of life and composite health score. ResultsMedian age of the sample was 60 years (range 50-94). Women HIV-infected (aOR 0.15, 95% confidence interval (CI) 0.08-0.29) and HIV-affected (aOR 0.20, 95% CI 0.08-0.50), were significantly less likely than men to be in good functional ability. Women's adjusted odds of being in good overall health state were similarly lower than men's; while income and household wealth status were stronger correlates of quality of life. HIV-infected participants reported better functional ability, quality of life and overall health state than HIV-affected participants. Discussion and Conclusions The enhanced healthcare received as part of anti-retroviral treatment as well as the considerable resources devoted to HIV care appear to benefit the overall well-being of HIV-infected older people; whereas similar resources have not been devoted to the general health needs of HIV uninfected older people. Given increasing numbers of older people, policy and programme interventions are urgently needed to holistically meet the health and well-being needs of older people beyond the HIV-related care system. <br/

Health and functional status among older people with HIV/AIDS in Uganda.

Background: In sub-Saharan Africa, little is known about the health and functional status of older people who either themselves are HIV infected or are affected by HIV and AIDS in the family. This aim of this study was to describe health among older people in association with the HIV epidemic. Methods: The cross-sectional survey consisted of 510 participants aged 50 years and older, equally divided into five study groups including; 1) HIV infected and on antiretroviral therapy (ART) for at least 1 year; 2) HIV infected and not yet eligible for ART; 3) older people who had lost a child due to HIV/AIDS; 4) older people who have an adult child with HIV/AIDS; 5) older people not known to be infected or affected by HIV in the family. The participants were randomly selected from ongoing studies in a rural and peri-urban area in Uganda. Data were collected using a WHO standard questionnaire and performance tests. Eight indicators of health and functioning were examined in an age-adjusted bivariate and multivariate analyses. Results: In total, 198 men and 312 women participated. The overall mean age was 65.8 and 64.5 years for men and women respectively. Men had better self-reported health and functional status than women, as well as lower self-reported prevalence of chronic diseases. In general, health problems were common: 35% of respondents were diagnosed with at least one of the five chronic conditions, including 15% with depression, based on algorithms; 31% of men and 35% of women had measured hypertension; 25% of men and 21% of women had poor vision test results. HIV-positive older people, irrespective of being on ART, and HIV-negative older people in the other study groups had very similar results for most health status and functioning indicators. The main difference was a significantly lower BMI among HIV-infected older people. Conclusion: The systematic exploration of health and well being among older people, using eight self-reported and objective health indicators, showed that basic health problems are very common at older ages and poorly addressed by existing health services. HIV-infected older people, however, whether on ART or not yet on ART, had a similar health and functional status as other older people

Mass limit for the lightest neutralino

Indirect limits on the mass of the lightest neutralino are derived from the results of searches for charginos, neutralinos, and sleptons performed with data taken by the ALEPH Collaboration at centre-of-mass energies near the Z peak and at 130 and 136 GeV. Within the context of the Minimal Supersymmetric Standard Model and when $M_{\tilde\nu}\ge 200$ GeV/c^2, the bound $M_\chi>12.8$ GeV/c^2 at the 95\% confidence level applies for any $\tan\beta$. The impact of lighter sneutrinos is presented in the framework of SUSY grand unified theories; a massless neutralino is allowed only for a narrow range of $\tan\beta$, $\mu$, and the scalar mass parameter $m_0$. Finally, by including Higgs mass constraints and requiring that radiative electroweak symmetry breaking occur, more stringent bounds on $M_\chi$ as a function of $\tan\beta$ are derived.Indirect limits on the mass of the lightest neutralino are derived from the results of searches for charginos, neutralinos, and sleptons performed with data taken by the ALEPH Collaboration at centre-of-mass energies near the Z peak and at 130 and 136 GeV. Within the context of the Minimal Supersymmetric Standard Model and when $M_{\tilde\nu}\ge 200$ GeV/c~2, the bound $M_\chi>12.8$ GeV/c~2 at the 95\% confidence level applies for any $\tan\beta$. The impact of lighter sneutrinos is presented in the framework of SUSY grand unified theories; a massless neutralino is allowed only for a narrow range of $\tan\beta$, $\mu$, and the scalar mass parameter $m_0$. Finally, by including Higgs mass constraints and requiring that radiative electroweak symmetry breaking occur, more stringent bounds on $M_\chi$ as a function of $\tan\beta$ are derived