Lifelong Connections: Supportive Networks for People with HIV over 50

Social support networks

Expand existing project, program, or initiative (expanding and continuing ongoing, successful work)

As of 2021, there are over 27,000 PWH 50+ in LA County (LAC). Due to advances in antiretroviral therapies and supportive care, PWH 50+ now approach life expectancy levels seen in the general population. However, according to the U.S. Department of Health and Human Services, PWH 50+ are increasingly affected by various comorbidities such as cardiovascular disease, diabetes, and osteoporosis. They also face geriatric conditions like frailty, falls, and neurocognitive impairment, alongside significant psychosocial challenges. These include isolation, loneliness, lack of caregivers, depression, and behavioral health issues. PWH 50+ also experience pervasive stigma and lack of social support due to their diagnosis, which can further isolate them from other programs for older adults. These physical and mental health concerns, common in the general aging population, manifest earlier, more severely, and with greater frequency of comorbidities among PWH 50+.

Through seven evidence-based methodologies, HIVE connects clients to each other, builds supportive community and helps clients develop coping skills related to aging and HIV.
Shared Interest Groups: Small group-level intervention at cafés facilitated by staff and/or trained peers in English or Spanish. The topic chosen matches participants’ interests.
Mindfulness-Based Stress Reduction: Four-week small group intervention to increase awareness and acceptance of moment-to-moment experiences, difficult emotions and physical discomfort, an effective component of managing various conditions, including chronic pain, depression and stress.
Life Skills: Hosted in a small group format and focused on the development of behavioral skills – setting goals, managing finances, and seeking social support.
Health Education: Activities in both individual and group format focusing on clinical manifestations of HIV and aging: polypharmacy, nutrition education, comorbidities (cardiovascular disease, renal disease, cancer) and multi-disease management. Emotional Support: Weekly virtual peer support group to share feelings, coping strategies, and experiences of PWH 50+facilitated by the project coordinator.
Community Building/Social Networks: Activities include free events at cafés, group outings to movies, museums, board games nights, etc. Positive Self-Management: Weekly series of four, two-hour workshops to improve quality of life through interactive and experiential learning.

HIVE was launched in 2018, and in 2022 APLA Health began a new initiative to build programming for women with HIV (WWH) 50+ . WWH represent nearly 12% of all PWH in LAC, and 69% of cisgender WWH in LA are 50+, yet HIV+ cis women have the lowest levels of linkage to HIV care. Women with HIV experience depression, anxiety, and posttraumatic stress symptoms at higher rates than their male counterparts and more often than HIV-unaffected women. Given the primary focus of care has been on gay and bisexual men, there is a paucity of services designed for WWH in LAC. Moreover, many agencies who traditionally offered services to women no longer do so. HIVE intends to fill this gap in services for WWH in LA. Through our work with PWH 50+, and especially with increased programming for WWH 50+, we hope the future of LAC is one where the stigma and burden of living with HIV is eliminated, and HIV+ people are connected to a growing community of support. 

APLA Health uses our evaluation team to develop and implement a comprehensive plan incorporating formative, process, and outcome evaluation to assess quality of life, and changes in knowledge, attitudes, and beliefs around HIV and other social determinants of health. In terms of clinical HIV treatment, last year we saw 121 clients had improved CD4 counts (an important measure of HIV management), nearly every client reached or maintained undetectable levels of HIV (meaning they cannot pass on the virus), 7 clients were newly linked to HIV care, 33 clients were re-linked to HIV care, and 67 clients retained their HIV care. HIVE also links clients to support services. In the past year, there were over 450 separate instances of linkage to continuing education, food assistance, housing support, general health care, legal services, mental health support, addiction services, transportation assistance, support groups and utilities support.