Negative Lifestyle Factors Specific to Aging Persons Living with HIV and Multimorbidity.

The primary goal of medical care during the pre-antiretroviral therapy (ART) era was to keep persons living with human immunodeficiency virus (HIV) alive, whereas since the advent of ART, the treatment objective has shifted to decreasing viral loads and infectiousness while increasing CD4+ T-cell counts and longevity. The health crisis, however, is in preventing and managing multimorbidity (ie, type 2 diabetes), which develops at a more accelerated or accentuated pace among aging persons living with HIV. Relative to the general population and age-matched uninfected adults, it may be more difficult for aging HIV-positive persons who also suffer from multimorbidity to improve negative lifestyle factors to the extent that their behaviors could support the prevention and management of diseases. With recommendations and a viable solution, this article explores the impact of negative lifestyle factors (ie, poor mental health, suboptimal nutrition, physical inactivity, alcohol use) on the health of aging individuals living with HIV.

How Negative Lifestyle Factors Impact Aging Persons Living with HIVThis literature review highlights negative lifestyle factors experienced by aging persons living with HIV, including poor mental health (i.e., depression, cognitive decline), poor nutrition, physical inactivity, alcohol use, sexually transmitted infection, poor sleep quality, and treatment noncompliance as promoting diseases (e.g., type 2 diabetes, hypertension, obesity, cardiovascular disease) and early death. A possible solution to decreasing or eliminating negative lifestyle factors in the aging HIV-positive population is to develop disease prevention-focused teams in clinical and community settings. However, if team development is impractical, primary healthcare providers should routinely assess and monitor lifestyle factors (i.e., cognitive decline) and, if needed, provide appropriate referrals to licensed or certified specialists (e.g., psychologist, clinical dietitian, medical exercise specialist, or health coach).

Exploring the validity and statistical utility of a racism scale among Black men who have sex with men: a pilot study.

The primary purpose of this two-phased study was to examine the structural validity and statistical utility of a racism scale specific to Black men who have sex with men (MSM) who resided in the Washington, DC, metropolitan area and Baltimore, Maryland. Phase I involved pretesting a 10-item racism measure with 20 Black MSM. Based on pretest findings, the scale was adapted into a 21-item racism scale for use in collecting data on 166 respondents in Phase II. Exploratory factor analysis of the 21-item racism scale resulted in a 19-item, two-factor solution. The two factors or subscales were the following: General Racism and Relationships and Racism. Confirmatory factor analysis was used in testing construct validity of the factored racism scale. Specifically, the two racism factors were combined with three homophobia factors into a confirmatory factor analysis model. Based on a summary of the fit indices, both comparative and incremental were equal to .90, suggesting an adequate convergence of the racism and homophobia dimensions into a single social oppression construct. Statistical utility of the two racism subscales was demonstrated when regression analysis revealed that the gay-identified men versus bisexual-identified men in the sample were more likely to experience increased racism within the context of intimate relationships and less likely to be exposed to repeated experiences of general racism. Overall, the findings in this study highlight the importance of continuing to explore the psychometric properties of a racism scale that accounts for the unique psychosocial concerns experienced by Black MSM.