8/23/2017 feature story
HIV after 40 in Rural South Africa: Aging in the Context of and HIV/AIDS Epidemic
South Africa has the largest number of people living with HIV/AIDS in the world and a rapidly aging population. In recent years, with expanded availability of ART, many adults are aging with HIV, and also increasing numbers are acquiring HIV at older ages. Despite these population concerns, research on the impact of the HIV epidemic on older South Africans is scarce. This study examines life-course and contextual variation in HIV risk and protective behaviors in a rural sub-Saharan African population among a largely neglected demographic in HIV/AIDS research: adults aged 40-80. Our study draws on five data sources including: (1) the Agincourt Health and Socio-Demographic Surveillance System (AHDSS), with annual censuses of 90,000 people in 27 villages followed from 1992-2014; (2) nested cross-sectional survey data of 5,080 individuals (of whom 2,080 are aged 40+) on sexual behavior with HIV and chronic disease biomarkers (2010-2011); (3) 60 nested life history interviews with HIV-positive and -negative adults aged 40-80 (2013); (4) community focus group data from 77 respondents (2013); and (5) key informant interview data from health workers in 3 local health clinics (2013). We use these data to examine HIV risk and protective behavior in the transition from middle to older ages and the role of social context in shaping individual behavior. We expect our work to contribute to and directly impact HIV prevention programming in rural South Africa by leveraging more than 20 years of community relationships in Agincourt.
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