Aging with HIV in Sub-Saharan Africa

 With the development of effective antiretroviral therapies (ART) in the mid-1990s, HIV became a treatable although serious condition, and people who are adherent to HIV medications can attain normal or near-normal life expectancies. Because of the success of ART, people 50 and older now make up a majority of people with HIV in high-income countries and other places where ART is accessible. The aging of the HIV epidemic is a global trend that is also being observed in low- and middle-income countries, including countries in sub-Saharan Africa, where the greatest number of older people with HIV reside (3.7 million). While globally over half of older adults with HIV are in sub-Saharan Africa, we have little information about the circumstances, needs, and resiliencies of this population, which limits our ability to craft effective policy and programmatic responses to aging with HIV in this region. At present, our understanding of HIV and aging is dominated by information from theU.S. and Western Europe, where the epidemiology of HIV and the infrastructure to provide social care are markedly different than in sub-Saharan Africa. Aging with HIV in Sub-Saharan Africa addresses this gap in our knowledge by providing current research and perspectives on a range of health and psychosocial topics concerning these older adults from across this region. This volume provides a unique and timely overview of growing older with HIV in a sub-Saharan African context, covering such topics as epidemiology, health and functioning, and social support, as well as policy and program implications to support those growing older with HIV.

There are very few published volumes that address HIV and aging, and this is the first book to consider HIV and aging in sub-Saharan Africa. Most publications in this area focus on HIV and aging in Uganda and South Africa. This volume broadens the scope with contributions from authors working in West Africa, Botswana, and Kenya. The range of topics covered here will be useful to professionals in a range of disciplines including psychology, epidemiology, gerontology, sociology, health care, public health, and social work.

Mark Brennan-Ing, PhD, is Director of Research and Evaluation at the Brookdale Center for Healthy Aging at Hunter College, City University of New York. Dr. Brennan-Ing's research focuses on psychosocial issues affecting persons living with HIV and older sexual minority and gender diverse adults. They are Past-President of the State Society on Aging of New York (SSANY), a Fellow of the Gerontological Society of America (GSA), a Fellow of Division 44 (Psychology of Sexual Orientation and Gender Diversity) of the American Psychological Association, and past Board Member of the New York Association on HIV over Fifty (NYAHOF). They were the Principal Convener for GSA's HIV/AIDS and Aging interest group, a member of the American Society on Aging's LGBT Aging Information Network Leadership Council, and 2016 Chair of the American Psychological Association's Committee on Sexual Orientation and Gender Diversity. They were an invited member of the National Institutes of Health (NIH) Office of AIDS Research Working Group on HIV and Aging in 2011. Dr. Brennan-Ing has been recognized for their work by the Hunter-Brookdale Center on Aging, Pride Senior Network, and the New York State Office for the Aging. In 2017 they received the Walter M. Beattie Award from SSANY. Dr. Brennan-Ing was the lead editor of Older Adults with HIV: An In-depth Examination of an Emerging Population (2009) and the 2016 volume HIV and Aging: Interdisciplinary Topics in Gerontology and Geriatrics (vol. 42), which received a "High Commendation" from the British Medical Association. They have authored over 100 peer-reviewed articles, chapters, and books.

Kristen E. Porter, PhD, MAc, LAc, began working in the HIV field in 1994, first as a clinician, then as a nonprofit executive director of an HIV/AIDS integrative medicine clinic. After receiving her PhD in gerontology from University of Massachusetts Boston, she completed postdoctoral training at ACRIA's Center on HIV and Aging in New York (2015-2017). During that time, she was part of an international team of collaborating researchers on HIV and aging in sub-Saharan Africa. Her conference presentations on the topic include "Aging with HIV. Transgender Older Adults: Challenges, Resources, Resilience" (2019; 9th Annual LGBT Elders in an Ever Changing World, Salem State University, Salem, MA), "Older Adults with HIV in South Africa: Experiences of Intimate Partner Violence" (2016; 68th Annual Scientific Meeting of the Gerontological Society of America, New Orleans, LA), and "Complementary and integrative health (CIH) use in older adults with HIV" (2016; 21th International AIDS Conference, Durban, South Africa). Her research has centered on resilience among those aging with HIV, as well as sexual and gender minorities, and can be found in peer-review journals (such as Journals of Gerontology, The Gerontologist, Research on Aging, Clinical Gerontologist, Journal of Applied Gerontology) and the book Transgender and Gender Nonconforming Health and Aging (Ed. Hardacker et al., Springer, 2019).

Jennifer E. Kaufman, MPH, is a Senior Research Associate at the Brookdale Center for Healthy Aging at Hunter College, City University of New York. Her current work focuses on older people with HIV, sexual and gender minorities, and health messaging and technology access for older adults. Her interests also include health policy and the economics of aging, and her research on the wellbeing of older adults has covered a range of topics, such as creative aging programs, family caregiving, and racial disparities in the economic effects of dementia. Ms. Kaufman has an extensive editorial background at academic presses, journals, and textbook publishers, and in education and social policy research. She holds a master's degree in public health policy and management from the Graduate School of Public Health and Health Policy, City University of New York.

Catherine MacPhail, PhD, is an Associate Professor of Public Health in the School of Health and Society at the University of Wollongong, Australia. She has published extensively on HIV prevention in sub-Saharan Africa where her focus is on understanding how structural issues impact young women's HIV vulnerability and how older adults experience ageing with HIV. She is also working on whether HIV prevention technologies for women might be useful for eliminating HIV in Australia, sexual behaviours of diverse communities, and domestic and family violence. Her research publications appear in high-quality peer-reviewed journals such as Social Science and Medicine and Culture, Health and Sexuality and are widely cited.

Janet Seeley, PhD, is a social anthropologist by training. She is a Professor of Anthropology and Health at the London School of Hygiene and Tropical Medicine. Before joining the School in April 2014, she was Professor of International Development at the University of East Anglia. She worked for the Department for International Development (formerly ODA) as a social development adviser for 13 years (1987-2000). In that role she moved to Uganda 1989-1993 to establish the social science team within the then MRC/ODA/UVRI programme. In 2008 she returned to the now MRC Uganda Unit to head the social science programme. She will hand over her Programme leadership in March 2022. In 2014 she was asked to assist the social science team at the Africa Health Research Institute (AHRI) (Wellcome Trust funded) in KwaZulu-Natal, South Africa. She remains a faculty member at AHRI for social science and research ethics. Over 40 years, Janet has led research in Kenya, Uganda, Zambia, Malawi, India, Nepal, Bangladesh, Pakistan, and Papua New Guinea on social aspects of health and wellbeing, migration and mobility, poverty and gender.