Blog Wrap-Up

Aging with HIV is beginning to get the attention it deserves.  The issues affecting midlife and older people living with HIV have been  in the media, discussed by government and non-for-profit HIV and Aging organizations, and researched in the fields of science and medicine.  And, that attention is critical because it is estimated that by the year 2015 over half the people living with HIV will be aged fifty or older.

There needs to be more discussion about this issue at all levels, including: Expanding research initiatives on how HIV affects older bodies; Building policy and education programs that target midlife and older adults; Creating training modules for service providers; Establishing dialogues about the emotional, physical, social and financial consequences of living with HIV into older adulthood; And, providing support and community to people aging with HIV.

It has been personally enriching to be a part of this process through my work on Aging with HIV: A Gay Man’s Guide.  I’ve met some fantastic people who are committed to these issues.  And, I hope to continue to be a part of the discourse, as an educator and psychotherapist, providing training and supervision on the subject.  It has been a learning process for me, and I have grown as a clinician and teacher from the workshops I have given and attended across the country.

Since the publication of the book my clinical practice has expanded.  I find that balancing my work as a psychotherapist and as an educator fills my professional time.  So, I am going to take a break from maintaining the Aging with HIV blog.

The site will remain operational.  You can still use it to find resources and to contact me. Review some of the earlier blog entries to find links to articles and organizations that may be of interest.  You can use the links on the right hand column to find blog entries or read my January 23rd post, Annual Review, which offers an overview of what I’ve written in the blog this year.

Thank you for being a part of this journey with me.  I look forward to seeing what new developments are on the horizon.

HIV and Aging: American Society on Aging (ASA)

In a recent article for the American Society on Aging, Nathan Linsk, considers the issues faced by older adults as the significant challenges for the fourth decade of HIV.  The article discusses the physical and emotional challenges long term survivors face as they live longer than ever expected.  Linsk summarizes recent research developments in the field, offers links to articles, and lists resources available.

To read the article go the the ASA website.

A Poem A Day

As part of my New Year’s resolution I have been reading one poem from Walt Whitman’s Leaves of Grass every day.  This one resonated with me as an author and psychotherapist interested in themes of identity:

When I Read The Book

When I read the book, the biography famous,

And is this then (said I) what the author calls a man’s life?

And so will some one when I am dead and gone write my life?

(As if any man really knew aught of my life,

Why even I myself I often think know little or nothing of my real life,

Only a few hints, a few diffused faint clews and indirections

I seek for my own use to trace out here.)

 

Annual Review

It has been an exciting year since the publication of Aging with HIV: A gay man’s guide.  I have met a lot of great people around the country and overseas who are keeping conversations going about the challenges of aging and how people living with HIV can define optimal aging for themselves.

There have been many developments in the field: SAGE developed a policy paper on Aging with HIV; There was an historic White House meeting on HIV and aging; Interesting findings were discussed at the Baltimore Conference on HIV and Aging, the SAGE constituent conference and the 2nd Annual Conference on HIV and Aging in Austin; The HIV and Aging Group built community on Facebook; The National LGBT Aging Resource Center was created; Clinical Guidelines for Medical Management of HIV and Aging were released; and Caring and Aging with Pride published its report on LGBT Aging in the United States.

Aging with HIV was discussed in print and on the web: I talked with Mark S. King on MyFabulousDisease.com; The Philadelphia Gay News; The New York Times; Edge Magazine; And, the book was reviewed in The Bay Area Reporter, Lambda Literary Review, and The Gerontologist. And, I’m looking forward to the publication of an interview with Neal Broverman in next month’s Advocate.

It’s been quite a year!

I am looking forward to keeping you posted on new developments in the field.  Aging with HIV is an expanding field.  I am hoping that readers continue to share insights, information, and personal stories with me, so that I can pass them on to the community and keep the conversation going in 2012.

Hide/Seek at the Brooklyn Museum

I don’t think I could have been more proud of my cultural history as a gay man than I was last Saturday on Queer night at the Brooklyn Museum.

What could be more empowering than to dance to Sylvester’s “You Make Me Feel,” with hundred’s of LGBTQ people of diverse ages, ethnic, and racial backgrounds surrounded by priceless works of art in one of the oldest and largest art institutions in the United States?

The evening was to celebrate the ongoing Hide/Seek exhibit, and I knew it was going to be special as I entered the building.  The museum, which I have been going to since I was a child, seemed transformed by the energy of the crowd.  People were milling about, laughing and expressing affection with ease.  There were two venues for music, live and DJ.  And, although I usually hate standing in line, I waited patiently to enter the exhibition, feeling like I was part of something monumental that night.

HIDE/SEEK: Difference and Desire in American Portraiture is billed as “The first major museum exhibition to focus on themes of gender and sexuality in modern American portraiture.”  It was originally exhibited at the Smithsonian Institution, National Portrait Gallery with some controversy and will be on display at the Brooklyn Museum until February 12, 2012.

The exhibit documents the contributions of LGBT artists from the 19th century to the contemporary era.  It was a lesson in art history, and I learned not only about the impact of LGBT artists, but that many famous works were created by artists that I never knew were gay.  The works included in the exhibit tell us the story of gay life through the eyes of great artists of their day.  For example, I was struck by the soulful expression in “Arnold Comes of Age,” Grant Wood’s self-portrait (the painter of American Gothic).  He shows us how difficult it is to be a gay man in Middle America in 1930.  A walk through the exhibit documents the pain and suffering, joy and daring these great gay and lesbian artists endured through their work.  As the exhibit moved into the contemporary era, the impact of AIDS and works of current artists, I was able to reflect on my own life as a gay man, and could see how my experiences fell into a context of gay liberation and identity formation documented in art.

And, later, on the dance floor I felt deep gratitude for all the LGBT artists, activists, and people from all walks of life, who through their work and existance helped create a world where I could hold my husband’s hand at the Brooklyn Museum and feel proud of being gay.

To find out more about the exhibit go the the Brooklyn Museum.

Caring and Aging with Pride

Caring and Aging with Pride, the first national federally-funded project to examine LGBT aging and health, recently released a report of its findings.  The study included a national community-based survey of over 2,500 LGBT older adults from diverse walks of life.  This research provides a “historic new window into the health and lives of LGBT elders in America.”

The report is comprehensive and examines several areas of older people’s lives, including: Physical health, mental health, healthcare access, health behaviors, services/programs, HIV disease, and caregiving.  From their intensive research this group of recognized scholars conclude that LGBT older adults are a “resilient yet at risk population.”

Some key findings illustrate the complex reality of LGBT aging in America.  In the 88-page report a few statistics were particularly disturbing to me.  Respondents reported high rates of loneliness, disability and depression, and fewer social supports than found in the general, non-LGBT aging population.  Most had been victimized at some point in their lives, and many had been victimized multiple times, because of their perceived sexual orientation or gender identity.  The participants reported significant barriers to accessing health care, including discrimination, receiving inferior care, and inadequate care from providers who they can not “come out” to or who are insensitive to LGBT issues.

Yet, there were findings in the report that point out the strengths of LGBT older adults.  Many were involved in their communities and engaged in wellness, as well as physical activities.  They were contributing members of their communities and have distinct networks of support consisting of peers, partners and friends.  And, a large majority feel positive about belonging to the LGBT community.

The report concludes with a strong call to action that addresses steps we can all take in the areas of  policy, services, education, and research.

I am excited and encouraged by the breadth and quality of this research.  This project represents a significant step in addressing the needs of Lesbian, Gay, Bisexual, and Transgender older adults.  The findings will help researchers, policy makers and service providers, like myself, do our jobs more effectively.

I encourage you to go to the Caring and Aging with Pride website to read the full report or to view the brief Executive Summary.

Gay Marriage Victory Still Shadowed by AIDS: New York Times

In today’s New York Times Austin Considine writes about gay marriage and the bittersweet victory it represents for men in midlife who have lost loved ones to the AIDS epidemic.  Considine interviewed several gay men who share their feelings about this previously unimaginable day in New York history.  There is happiness and rejoicing, but also sadness and grief.  I talked with Considine about my experience and how even successes can trigger old feelings of loss.  I think that many gay men will relate to these men and find support in their stories.

New Guidelines For Medical Management of Older Patients Living with HIV Released

Last week the American Academy of HIV Medicine, the American Geriatrics Society and the AIDS Community Research Initiative of America (ACRIA) published recommended treatment strategies for clinicians managing older patients with HIV.  This is a major step in the medical treatment of HIV recognizing the unique and complex medical issues faced by this growing population.  It is the first time best practice guidance has ever been developed for HIV practitioners and other health care providers who treat diagnose and refer older patients with HIV disease.

The report contains specific guides provided for Diabetes, Cancer, Hypertension, HepC etc. as well as HIV testing and Sexual Health and more. While it is directed at practitioners, people living with HIV may want to familiarize yourselves with the recommendations and discuss their relevance to your care.  The full report is 76 pages, but an executive summary outlines the treatment recommendations in each area.

To view the overview, executive summary, or full report go to the American Academy of HIV Medicine webpage.

World AIDS Day 2011

Do you remember, remembering?  When we used to take a moment of silence at gay pride? When every meeting we attended on HIV began with an acknowledgement of those that were no longer with us?  When every World AIDS Day we talked about AIDS, and the overwhelming impact it has had on all of our lives?

Did you take that time today?  I’m not sure if I would have if I weren’t writing this blog.

But, as soon as I stop what I am doing to reflect on World AIDS Day.  In less time than a blink I am flooded with memories.  I remember Roger who died in 1991, five years before Protease Inhibitors would reshape for so many what it meant to live with HIV.  He took so many medications, only in the end to stop everything and attempt to fight his illness with the power of love.  I remember Michael who died the following year.  I was 24 and I think he was a year or two older.  Just a child.  But, I didn’t know that at the time.

I remember so many lovers and friends who are no longer here.  So many strangers on the street, whose faces I will never see again.  A generation wiped out by the epidemic.

And, still, I remind myself that it is not over.  That people all over the world are getting exposed, becoming ill and dying from HIV-related illnesses.  That so many friends who have survived AIDS, continue to deal with heart disease, cancer, diabetes, lipodystrophy, cognitive challenges, and other HIV-related (or not HIV-related?) illnesses.

I consider the new challenges that accompany living longer than expected –   Rebuilding lost careers, developing new social circles, managing survivor guilt, living through loss, and adapting to aging – to name just a few.

I reflect on the impact the epidemic has had on all of our lives.  The losses, and the strategies we developed to cope.  The opportunities that we could not avail ourselves of and the strengths we acquired fighting (literally and figuratively) to care for each other.  And, I recognize the scars that I acquired from surviving those battles – how they are now a part of my constitution, just like my family and my sexuality shaped my identity growing up.

People sometimes ask me, “Why should I remember those things?  They are just going to make me sad.”  There are so many responses to that question.  First, I say, “If just thinking about the past makes you sad, then you were probably sad already.”

Avoidance is a problematic coping strategy.  When we don’t deal with our feelings they tend to get expressed in other ways.  Just like a dammed river creates flooding in other low lying areas, unacknowledged feelings can leak out and create problems in other areas of our lives.  When we know what we are feeling, we can choose what we want to do with those feelings.

I have seen so many reactions to grief: sadness, fear, excitement, guilt, anger. In my work I help people to have all their feelings.  I’ve found that feelings tend to come and go.  Happiness, sadness, deeply felt, still passes.  Resilience means acknowledging losses without getting mired in grief.

Rituals help us to make our feelings tangible.  Lighting a candle, visiting a significant place, talking with friends, writing a blog are gestures that offer us the opportunity to mobilize our feelings into actions that honor ourselves and those that we remember.

Reminiscing can be healing, especially as we age.  Our memories connect us to the past, reminding us of who and what were once important to us.  We can draw strength from people and experiences from our past, but only if we can allow ourselves to remember them.  Reminiscing offers an opportunity to redefine ourselves in the present.  Our recollections contain tools that we can use to manage upcoming challenges.

The men I interviewed for Aging with HIV talked about how living with HIV went from being a trauma to become “a part of our lives.”  The landscape of AIDS has changed for all of us, and we can each benefit from taking the time to reflect this World AIDS Day.

 

Update from the 2011 HIV/AIDS and Aging Symposium

The 2011 HIV/AIDS and Aging Symposium held in Austin, TX last week was an inspiring event.  I was proud to be a participant in a true community-based, grass-roots initiative to address the concerns of this often invisible, yet growing population.  It was informative. – I learned a few things that I didn’t know about HIV/AIDS and Aging.  But, even more importantly, the symposium brought together people from diverse backgrounds to discuss how the issue is impacting their community.  The symposium was a great model for how communities across America can respond to the issue of Aging with HIV.

After registration and a light breakfast (that I truly appreciated at 8AM) the 90 plus participants gathered for the opening remarks.  The first speaker, Justin Irving, from the Austin/Travis County Health and Human Services presented the HIV/AIDS demographics and emerging population trends.  This was a good grounding for the event offering a local and national context for the discussion.

The group divided into two “breakout sessions” – Aging 101 and HIV/AIDS. I attended the HIV/AIDS seminar presented by Jennifer Herrera from AIDS services of Austin.  It was  a great overview of the illness in which I learned a few things about HIV transmission.  She also focused on how HIV is affecting folks in Austin, and emphasized the need for prevention geared toward older people.  I walked away with some ideas on how to help social workers talk about sex and HIV education.  I am sure that the concurrent session offered by Annette Juba from AGE was as informative and community building as the one I attended.

We broke for lunch, and I attended a “leadership luncheon” with the executive directors from area agencies servicing seniors and people living with HIV.  I left the lunch feeling hopeful that there was a forum in this community for leaders from both fields to come together and problem solve to address this issue.

It was then my turn to bring everyone together.  My talk was entitled, “Aging with HIV: The challenges of living longer than expected.” I gave an overview of the demographics nationwide on HIV over fifty and talked about why Aging will be “the issue” in HIV in the coming years.  By 2015 the majority of people living with HIV will be over fifty.  While this is a hopeful statistic, it is also a troubling one, since we currently know very little about what it means with HIV.  I presented the public health challenges this trend creates.  I talked about the issue of mortality and medical challenges that midlife and older people face as they live longer with HIV.  And, I presented the complex psycho-social challenges that accompany aging with HIV.  We concluded the session with a discussion of the unique constellation of issues faced by people living with HIV over age fifty, the similarities and differences with younger folks living with HIV, as well as their HIV-negative peers.  Experts in the fields of aging and HIV were able to share their experience to help each other find solutions for the challenges of living longer than expected.

The final panel was made up of midlife and older people living with HIV and local agency workers servicing this population.  They offered their experience and gave real faces to the concerns of people living with HIV in the Austin community.

The HIV/AIDS and Aging Symposium Committee created an effective model for sharing of information and ideas that can be replicated in communities throughout the country.