UCSF to Study Aging with HIV
Doctors at the University of California, San Francisco (UCSF), appreciate the unique challenges faced by their patients as they age with HIV. That is why the University has received funding to develop and evaluate programs that integrate HIV and geriatric services for HIV/AIDS patients who are 50 and older. Researchers at the San Francisco Department of Public Health and UCSF received a three-year grant to study new models of care and offer best-practice guidelines for treating HIV and aging throughout California.
To find out more about this timely study go to the UCSF website.
Do You Know About HAG?
Here’s what they say about HAG on their Facebook page: “Affectionately called HAG, the HIV Aging Group discusses all issues related to the senior HIV patient experience.”
If you are a facebook user you can join their discussion. Just go to your fb page, search for HAG and then put in a request to join.
Preparing for the Aging HIV Epidemic
POZ magazine on line listed this video on Aging with HIV as one of the top ten for 2010. The article, posted on May 12th by Willette Francis, includes a video of GMHC Executive Director, Dr. Marjorie Hill, reporting the results of their study, “Growing Older With the Epidemic: Aging and HIV.”
In case you missed the original article and video, here is the link: http://www.poz.com/articles/GHMC_HIV_aging_2296_18404.shtml
Stay Connected
The final post in December’s Self Care series is on staying connected.
The research demonstrates that having a rich social support network is integral to optimal aging with HIV. Having friends and family helps one to cope with some of the challenges of aging, and of living with HIV. The presence (or absence) of social support affects emotional and physical health. It is not merely the number of friends that matter, but how reliable they are in a variety of ways, and your satisfaction with these supports that matters.
But, many gay men have lost their entire friendship networks to the AIDS epidemic. Add to this the normal losses that occur with aging and we see that just as people need more support from friends and family to deal with the challenges of aging with HIV, they have fewer people in their life to rely upon.
The challenge at this stage of life is to maintain, reconnect, and rebuild social networks. There are many obstacles to rebuilding social networks. You must know yourself, what you like in a friend, and what you need in a friend (which are not always the same.) You also have to be willing to take a risk and even to experience the potential for more losses. A difficult challenge for people who have lost many friends in the past.
I’ve pulled a few suggestions on rebuilding social networks from Aging with HIV: A Gay Man’s Guide:
Renew old acquaintances. Contact friends from your past or deepen your involvement with extended family.
Seek out people with whom you have things in common. Join an organization. Many of the men I spoke with are in HIV or gay men’s support groups. But the options are as broad as your interests. Are you into doll collecting? Environmental issues? Chess? The Avengers? Macrobiotic cooking? Salsa dancing? There is a club for you. Look at your local gay community organization, AIDS service agency, newspaper, or on the web to find a group that fits your needs.
Talk to a stranger. Strike up a conversation with someone you see at the supermarket, in the building where you live, or the restaurant on the corner. If you don’t know what to say, ask a question. People love to talk about themselves.
Diversify your networks. Your friends should include people from different backgrounds. The wider and more varied your network, the greater your ability to manage what life throws at you. There may be straight, younger, or HIV-negative people in your life who would welcome the opportunity to develop a closer bond.
Don’t wait for people to contact you. If you want to talk to someone, pick up the phone (and leave a message at the beep). Every day. I don’t know anyone who can read minds. No one will know that you need help if you don’t ask for it.
Consider professional supports. You may feel more comfortable reaching out to a psychotherapist, pastoral counselor, or social worker than a friend when you are depressed or anxious.
Get a pet. Pets are great companions. And when you’re walking the dog, who knows who you might meet?
Pursue (or maintain) a romantic relationship. A stable marriage at age 50 is one of the predictors of healthy aging at age 75.
Use the Internet to cast a wider net. The Internet is not a replacement for human contact, but it can be an effective tool to rebuild your social network. Several aging organizations serving the lesbian, gay, bisexual, and transgender (LGBT) and HIV communities have resources on the web. Don’t be afraid to join Facebook, Twitter, or LinkedIn. They are great tools to stay in touch with people of all ages.
Form a reading group. At the end of the book I outline a strategy to use this book in a group setting. But you can form a reading group on any subject that interests you. Start advertising by word of mouth and then consider where you can post a flier or put in an ad to best reach like-minded people, such as your office or a local bookstore.
Just as a garden needs constant tending before your new plant can take root, you must nurture your relationships for them to mature. Keep showing up. Stay in regular contact with your friends. Time can weaken the bonds of friendship. Find ways to stay in touch, such as the telephone or Internet. Similarly, don’t allow arguments or miscommunication to jeopardize a good friendship. Try to work out your disagreements by talking to each other, or ask a friend or professional counselor to help you mediate the problem. Remember, maintaining friendships is as important as forming them.
Staying Fit
The third post in the December Self-Care series is about staying fit. For me, the challenge of exercising is getting started. I never want to exercise, but I always feel better after. My strategy to compensate for my inertia is to include some form of physical activity into my weekly routine, that way I don’t have to think about it, I just do it.
The benefits of exercise are multi-fold. A balance of aerobic exercise, strength training, and stretching helps cardiovascular health while maintaining muscle mass, balance, and flexibility. Regular exercise is not only an integral part of physical health for people aging with HIV, but exercise can also help you reduce stress, manage anger, and improve your mood. In addition, there is evidence that regular physical exercise can actually forestall the onset of non-HIV-related dementia.
Calisthenics, rapid walking, jogging, dancing, and hiking are aerobic activities. Strength training––using weights or other forms of resistance––is increasingly found to be important for building muscle mass lost with aging. Stretching is an important part of any exercise routine, and it is especially important to increase flexibility as we age. Yoga is an ancient form of exercise involving the mastery of postures that increase flexibility and strength. I recently heard one yoga instructor refer to spinal flexibility as, “the fountain of youth.”
Your exercise routine should include aerobics, strength training and stretching. Exercise does not need to be strenuous. Start slow with achievable goals and respect your limits. You may want to consider getting started with a fitness professional. Before starting an exercise program be sure to discuss it with your doctor.
Next post: Staying Connected
Book Update: Printing Errors
I just learned from Oxford University Press that Aging with HIV: A Gay Man’s Guide was distributed this month with printing errors. They have agreed to reprint the book and will send out new copies in January. If you have a book with errors, you should be able to get a new one.
Eating Well
In the second installment to the December’s Self-Care posts, I wanted to discuss healthy eating. Well, actually, I do not want to discuss healthy eating, because I have to admit to everyone that I have not been eating well lately. With the release of the book, the stress of the holidays, and my inclination to eat more than I should at this time of year, I have put on a few pounds. So, I need to revisit this topic for myself and will bring you along for the ride.
You may have already made adjustments to your diet to adapt to HIV-related changes in your metabolism and the effects of medication. Aging, too, creates shifts in our body, and as we age we need to alter our diets to compensate.
I consulted with Dr. James Schmidtberger, from the Leicht Clinic, an HIV-clinic in New York City to get some guidance on eating well and aging with HIV. He offered some general suggestions in order to get us started. He also suggested following up with a doctor or nutritionist to respond to changes in your specific physical condition.
Here is what he had to say:
When we age we lose muscle mass and require fewer calories daily. Uncontrolled HIV can accelerate the loss of muscle mass. If you are concerned about HIV wasting you may be tempted to overeat. Without adequate exercise, this may result in excess fat which raises the risk of developing (or worsening) other chronic conditions such as diabetes and heart disease. This is why nutrition and exercise are so important to help you maintain your muscle mass. Nutrition is particularly important if you have other medical problems (such as high blood pressure, high cholesterol, diabetes, or prediabetes) or lipodystrophy. A balanced diet is important to help your body fight HIV and control (or prevent) those other conditions.
A good place to start is to assess your overall dietary habits. In general, you want to eat a balanced diet with plenty of fresh fruits and vegetables. A good rule of thumb is called the “plate method.” This is a simple way to devise a healthy meal and is recommended by the American Diabetes Association. Take your dinner plate and divide it in half. Fill one half with nonstarchy vegetables (such as spinach, broccoli, cauliflower, greens, salad, tomato, cucumber). Divide the remaining half again into two quarters. Fill one quarter with starchy foods (such as rice, pasta, corn, peas, whole grain breads/cereals). Fill the remaining quarter with proteins (lean meats, skinless poultry, seafood, tofu, eggs). Add a glass of nonfat or 1% milk or yogurt and a piece of fresh fruit. You can bring the plate method to the breakfast, lunch, or dinner table.
Consider the following small modifications. If you eat too much, try to limit your portions. If you drink soda, switch to seltzer or diet sodas. Avoid fast food. Switch to healthy oils, olive oil or canola oil, and avoid food with trans fats.
Depending on your situation, your nutritional needs may differ. For example, if you are fighting an opportunistic infection, your calorie requirements may be higher than usual. If you have heart disease, diabetes, or other complications, you may have specific dietary restrictions. Ask about nutrition. You may also want to consult with a nutritionist to assess your dietary needs.
Next week’s blog: Staying Fit
A Good Night’s Sleep
As we’ve been discussing on this blog , aging with HIV involves adapting to a great deal of change. One aspect of optimal aging with HIV is re-evaluating your coping strategies, to make sure they are meeting your changing needs.
This month we will be discussing Self Care. December can be a stressful month and you may want to make sure that you are doing everything you can to take the best care of yourself that you can.
Developing healthy sleep habits is an integral part of self care.
There are several things in life that could impact your sleep. Changes in medication, physical changes that accompany aging, stress, and environmental changes can all affect your ability to get a good night’s rest. The following are some recommendations for getting a good night’s sleep taken from Aging with HIV: A Gay Man’s Guide.
Many people’s sleep habits interfere with getting a good night’s sleep. For example, eating or drinking in bed, reading/playing cards in bed, and falling asleep with the TV on for background noise are just a few. These practices train your body to be awake in bed. If you are having sleep problems, try retraining yourself: go to sleep and get up at the same time every day, remove the TV from the bedroom, make your bedroom quiet and dark (use blackout shades if necessary), do not read in bed, and do not eat or drink in bed. The bed should be only for sleep (and sex). Establish a prebedtime ritual, such as turning off the TV and computer at least 30–60 minutes before bedtime, changing out of your day clothes, and flossing and brushing your teeth, to prepare your body for sleep. When you feel tired, go to bed. If you cannot sleep after 20 minutes, get up and leave the bedroom, but don’t turn on the TV or computer. Wait until you feel tired and try again. If you continue to have trouble sleeping, you should bring it up with your doctor.
Next post: Eating Well.
Self Care
Someone in AA recovery recently told me that alcoholism is a three-fold disease, “Thanksgiving, Christmas, and New Year’s.” The risk at this time of year is to turn to alcohol as a way to cope with stress. But, the holidays are not only challenging for alcoholics. They are wrapped up with intense meaning for many of us, and, it is difficult not to feel pressured at this time of year. The holidays can also stir up feelings of grief, sadness, and loneliness, and these feelings can be compounded when it seems that everyone else is having fun but you. And, moods can darken when the weather starts getting colder, and the days become shorter.
But, there are things we can do to take care of ourselves at this time of year. That is why for the month of December I will be dedicating my blogs to the subject of Self Care.
Self care can be both simple and difficult. A few activities may mean making only small adjustments to your daily routine. However, maintaining a regimen of self care can also feel like work. People can be surprised at the discipline it takes to take care of oneself.
Please feel free to add your thoughts at any time. I hope that this will spark a discussion about self care and aging with HIV.
Next post: Healthy Sleep Habits
World AIDS Day
We are at the end of the third decade of the World AIDS epidemic. The disease has impacted the lives of people throughout the globe and reshaped societies. Today the epidemic has a very different meaning in the developed world than twenty-nine years ago. Because of advances in the treatment of HIV disease, Aging is now THE issue in the United States. Not only are people living longer than expected, but by 2015 the majority of people living with HIV in the US will be over fifty years old. The aging of HIV means that we need to develop new policies and treatments for the disease. People living with HIV must adapt to the challenges of growing older and develop new mindset of Optimal aging with HIV. To read my World AIDS day article for Edge magazine follow this link – Edge magazine.
AHA Project 