Using a telephone support group for HIV-positive persons aged 50+ to increase social support and health-related...

Middle-aged and older persons living with HIV/AIDS have unique needs arising from the physical, mental, and social changes associated not only with normal aging but also related to living with a chronic illness. To address these needs, two 10-week telephone psychoeducational support groups were offered for HIV-infected persons aged 50 or older. Each group was cofacilitated by a registered nurse and a social worker; each session was 50-60 minutes every Friday; approximately 1-5 clients participated with an average number of 3 clients and there was no charge to the participants. The issues addressed in the group were: (1) staying healthy; (2) symptom management; (3) understanding other chronic illnesses; (4) understanding diagnostic tests; (5) strategies for effective interactions with the health care provider; (6) optimizing HIV/AIDS medication use; (7) understanding new developments in HIV treatment; (8) coping with losses; and (9) finding commonalities. There were unique challenges. Boundaries of respect were more difficult to maintain in a teleconference, as opposed to an in-person group. Nonverbal cues were impossible to interpret and therefore greater sensitivity was required to gauge the impact of borderline, less controlled group members, especially in relationship to other group members who may tend to be less assertive. One group member withdrew because his hearing was impaired and the telephone modality was just too challenging. It has been found that middle-aged and older adults living with HIV/AIDS with greater depression identify a need for information and support. It is crucial to share concrete information, identify symptoms clearly, and explore the use of effective and ineffective medications and treatments. The psychosocial concerns are very real and encouraging group members to open up to one another to create a cohesive community of sharing is equally important. Although the use of teleconference technology makes this more difficult, the attempt to create a situation that facilitates connections with another individual is one strategy to decrease geographic or logistical isolation.