"Ask those who are ahead about a buffalo": Well-being of African grandparents with HIV

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Aging with HIV in Sub-Saharan Africa: Health and Psychosocial Perspectives


Older adults with HIV in sub-Saharan Africa often care for grandchildren, but the impact of caring on well-being has not been studied extensively. We examined 208 older adults with HIV in Uganda (n = 100) and South Africa (n = 108); 90% were grandparents and 47% cared for grandchildren (carers). Carers were vulnerable compared to noncarers and nongrandparents with a significantly higher average number of comorbidities (4.1 vs. 2.7 vs. 1.9, respectively) and depressive symptoms (11.3 vs. 9.1 vs. 7.3, respectively). However, carers had significantly lower average HIV stigma scores (32.2 vs. 35.5 vs. 42.5, respectively) and significantly higher perceived emotional support (6.1 vs. 5.7 vs. 5.4, respectively). Multiple regression analysis indicated that comorbidities and financial need mediated the positive association between grandparent carers and depression. The negative association between being a carer and stigma was no longer significant when controlling for other factors such as project site. We observed a significant Site x Comorbidities interaction indicating that the positive association between comorbidities and stigma was stronger for Ugandan participants. Findings highlight the need for improved management of comorbidities and the need for better financial security among older people with HIV in sub-Saharan Africa regardless of caregiving involvement.

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