HIV/AIDS and older people : a case of Nairobi city slums, Kenya

Abstract

Older people may be affected by HIV/AIDS indirectly through their role as caregivers to people who are suffering from AIDS and through caring for orphaned children. HIV/AIDS also poses a threat to old-age support due to the death of adults in economically active age who would have otherwise provided care and support to older people. This study sought to explore what older people perceive as their main HIV/AIDS concerns and to examine the association between providing care to someone with HIV/AIDS, and, socio-economic and health outcomes. The study was conducted in a demographic surveillance site covering two slum areas of Nairobi, Kenya using both quantitative and qualitative data. A total of 2,061 men and women aged 50 years and older were interviewed in a survey conducted by the author. The survey was supplemented by other datasets from the demographic surveillance systems and indepth interviews. To understand the association between care-giving and socio-economic and health outcomes, HIV caregivers were compared with other caregivers and non-caregivers. HIV caregivers were found to live in larger households and in households with frequent in or out-migration of individual members compared with the comparison groups. They were also more likely to live in households with a large number of children below the age of 15 years. Whereas a high proportion of HIV caregivers were ranked highly in terms of wealth status, differences in per capita income and expenditure were not significant when household size and other factors were accounted for. The study found a dependence on salaries as a key source of income among HIV caregivers which presents a challenge for older people who are sometimes discriminated against in the labour market. The groups were also compared on various self-reported health indicators namely functionality and disability, having a severe health problem and quality of life. Multiple regression analysis which controlled for age and various socio-economic characteristics found no significant differences between female HIV caregivers and the comparison groups, however, significant differences were observed among the males where HIV caregivers were more likely to report disability and having a severe health problem compared with non-caregivers. This finding highlights a gendered variation in outcome and is possibly an indication of the differences in gender-role expectation and coping strategies. Another key finding from the study is that apart from the indirect ways through which HIV/AIDS affects older people, they are also concerned about HIV infection among people in their age group, a group that has received almost no attention among researchers and intervention policies and programs targeted at preventing the transmission of HIV/AIDS.

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