As the U.S. reaches an important milestone this year in the fight against HIV with more than half the people living with the virus older than age 50, the University of Pittsburgh Graduate School of Public Health is launching a study to determine ways to promote health among aging gay and bisexual men, who make up about two-thirds of the people aging with HIV.
In an effort to create strategies for use in public health outreach nationwide, the research team will be taking an innovative approach to the study by looking for protective factors - called "resiliencies" - that are helping keep some men with HIV healthy and could be extended to other men, rather than simply fixing health problems as they arise. This research is funded with a three-year, $2.1 million grant from the National Institutes of Health (NIH).
"We celebrate that medications now exist to enable people with HIV to live well into old age," said study principal investigator Ron Stall, Ph.D., M.P.H., director of the Center for LGBT Health Research at Pitt Public Health. "But we also need to recognize that the health complications that come with aging - both mental and physical - are compounded when you're living with HIV. It is critical that we develop research-based programs to support HIV-positive people as they age."
The project will regularly survey 1,850 HIV-positive and -negative men participating in the Multicenter AIDS Cohort Study (MACS), an ongoing research study that has enrolled thousands of men in Baltimore, Chicago, Pittsburgh and Los Angeles over the past 30 years to participate in research on HIV/AIDS. The Pittsburgh arm of the study is the Pitt Men's Study.
The study aims to tease out why some gay and bisexual men remain healthy well into later life, even with multiple risk factors for conditions such as depression and substance abuse. The research team will then determine strategies that could help all gay and bisexual men adopt resiliencies - whether it's strong friendships, positive family ties, good coping skills or something else - that will give them a better shot at healthy aging, particularly when living with HIV.
The research team also will look at whether changing rates of resiliencies over time are associated with changes in substance use and other psychosocial health problems, as well as HIV-related health outcomes and medication adherence.
"Aging can be hard even when you have very few health risks," said Dr. Stall. "A gay man who came of age in a much less accepting era and is positive for HIV has the odds stacked against him. He's at greater risk for depression and substance abuse; he might not have prepared for retirement because he didn't expect to live to reach it; and he may eventually need long-term care because he's at greater risk for complications from diabetes and heart disease. And yet there are men facing all these risks who are defying the odds and leading healthy, happy lives. We could - and should - all learn from them."
Additional core investigators on this project include Michael Plankey, Ph.D., of Georgetown University; and James Egan, Ph.D., Mack Friedman, Ph.D., and Dan Siconofli, Ph.D., all of Pitt Public Health.
This research is funded by NIH grant R01 MD010680.