Program Has Real Impact on Seniors
By: Dr. Jennifer Hillman, Professor of Psychology and Coordinator of the Applied Psychology Program
As noted by Dr. Patrick DeLeon, former President of the American Psychological Association, the goal of psychology is to make what we know about human nature understandable to others. We are charged to find ways to share psychology “in big and small ways, in many different settings with many different people.” Consistent with this edict, the focus of Applied Psychology is to understand psychological phenomena that have practical implications.
In the Applied Psychology program at Penn State Berks, we are fortunate to have a number of talented faculty members with expertise in a variety of research areas. Assistant Professor Dr. Joanna Garner examines the study behaviors and note-taking skills of students in order to actively promote student learning. Associate Professor Dr. Eric Lindsey has been granted nearly half a million dollars by The Department of Health and Human Services to study parenting styles among Latino families. Instructor Dr. Marilyn Mussomeli has been selected as a National Institutes of Health Scholar in the area of multiculturalism and spirituality. And Associate Professor Dr. Brenda Russell examines the attitudes of both women and men toward domestic violence and assault.
My research focuses primarily upon HIV and AIDS among older adults (defined here as those over the age of 65). Few people, including health care professionals themselves, know that more older adults have died of AIDS than soldiers from both sides of the Vietnam War, and that the oldest person with a documented case of AIDS was an 86-year-old Caucasian heterosexual woman.
Although more than 11% of all new AIDS cases are among older adults and the rate of infection among newly diagnosed older adults is increasing at nearly twice that among teenagers, older adults are significantly less likely to receive age-specific HIV educational materials and are less likely to engage in HIV testing.
Unfortunately, aging itself poses unique risk factors in relation to HIV/AIDS. A general decline in immune system functioning results in a greater likelihood of contracting the HIV virus, per exposure, when compared to younger adults. The early symptoms of HIV infection among older adults, including weight loss, memory loss, and confusion, are often mistaken for “typical aging” or Alzheimer’s Disease. Older adults also tend to experience more side effects and less overall response to antiviral medications, and suffer greater mortality than younger adults.
A number of gender-specific issues also appear in relation to HIV/AIDS in later life. Older women are significantly more likely to have limited or no experience with condoms when compared to younger women. In addition, postmenopausal women are at greater risk of contracting HIV through sexual contact in response to various hormonal changes compared to younger women.
Primary care physicians typically fail to discuss potential high risk behaviors with their older patients in general, and older women miss the routine HIV screenings associated with pregnancy. Older women also are more likely to become “HIV affected” as caregivers for adult children or grandchildren with AIDS.
An initial examination of older adults’ knowledge and attitudes about HIV among a sample of community-living women and men in Berks and Lehigh counties indicated that even in this new millennium, elderly adults themselves have limited knowledge of HIV transmission, prevention, and detection.
For example, more than 75% of the seniors believed that AIDS was not a problem among older adults, and nearly 25% thought that you could contract HIV from a mosquito bite, by someone coughing on you, and by giving blood. More than 10% agreed that you could get HIV by using public toilets.
Less than one tenth of the older adults sampled knew that older adults, and particularly older women, were at greater risk of contracting HIV via heterosexual contact than younger adults. More than three quarters incorrectly believed that the new AIDS medications worked as well for older adults as they do for younger adults. Finally, 70% of the seniors did not know where they could get an HIV test for free.
Consistent with these findings, no national program or media campaign exists to provide essential HIV/AIDS education for this age group. In response, a unique partnership between Penn State Berks and the Berks County Office on Aging fostered the development of “AIDS Is Ageless,” an intergenerational program designed to identify distinctive risk factors for older adults, address myths and stereotypes, identify behaviors that can prevent the spread of HIV, and empower seniors to discuss HIV with doctors, partners, friends, and family.
This program also was supported by a generous grant from the Pennsylvania Department of Health, the Berks County Community Foundation, and the Berks County AIDS Network. Because older Latinos represent one of the fastest growing, but typically overlooked segments of HIV-infected adults, particularly including older women infected via heterosexual transmission, the program was also adapted for use with a Spanish-speaking audience, and delivered at various senior centers with the assistance of interpreters.
With the help of a number of specially trained psychology students, we conducted the program with hundreds of older adults in senior centers in multiple states, and incorporated handouts, brochures, and active-learning activities into the program. An analysis of 100 individual participant interviews revealed that they felt more positive than negative about their intergenerational learning, and about discussing HIV with others. Two months after the program, our older adult participants also reported increased knowledge of HIV and AIDS as assessed by their answers to various items on the Centers for Disease Control’s National Health Interview Survey’s AIDS Knowledge and Attitudes section.
An unexpected yet positive finding was that more than half of the older adults interviewed said that they would be comfortable talking to their grandchildren about HIV. As noted by one participant, “Give me some extra [condom] samples, would you? I’m going to give them to my grandson along with some straight talk about this [HIV] … I don’t think his mom is going to do it.”
Another older woman who participated offered, “Thank-you for not treating us like children. No one should be afraid to talk to us. How do you think all of you young people got here anyway?”
Perhaps more importantly, one elderly woman approached us after the program, crying openly. She asked, “So I can hug someone without getting it [HIV]? You mean I can really hug my daughter now?”
This woman had a daughter dying of AIDS, and literally was afraid to touch her for nearly two years. This type of monumental, positive experience and influence on someone’s life drives us to engage in applied research, even if the results are not always easy to deconstruct, or the projects easy to develop or employ. Even though we have generated significant empirical data to indicate that “AIDS Is Ageless” is effective along many dimensions, giving a mother another chance to hold her child is sometimes justification enough.