Understanding resiliencies of healthy aging among HIV-positive and HIV-negative gay or bisexual men in the US

Posted in GUMC Stories

FEB 3, 2016–In 2016, nearly 35 years since the first diagnosed case of AIDS, more than half of all people living with HIV are older than age 50 – an incredibly important milestone, says Michael Plankey, PhD, associate professor of medicine and an infectious disease epidemiologist at Georgetown University Medical Center.

However, little is known about the factors that contribute to healthy aging among gay and bisexual men, who make up about two-thirds of those living with HIV. With a five-year, $2.1 million grant from the National Institute of Minority Health and Health Disparities (R01MD010680-01A1), Plankey is working with Ron Stall, PhD, professor and director of behavioral and community health sciences at the University of Pittsburgh Graduate School of Public Health, to identify those factors, or “resiliencies.”

“The resiliencies that help to keep men with HIV healthy and prevent HIV infection among uninfected men could be a combination of things, such as strong friendships, positive family ties, good coping skills, ease with who they are or other health and behavioral factors,” Plankey says. “Harnessing these strengths could be used to design robust positive interventions, rather than designs based on blaming victimization that we know have not worked.”

The research funding will allow Plankey and Stall to conduct a large longitudinal study among 1,600 gay or bisexual men aged 40 or older with and without HIV participating in the Multicenter AIDS Cohort Study (MACS).  MACS started in 1983 and has, to date, included more than 7,000 men in four centers — Johns Hopkins, University of Pittsburgh, Northwestern and UCLA. Plankey is a senior co-investigator for the Baltimore-Washington site of MACS, in collaboration with Johns Hopkins University Bloomberg School of Public Health.

Study participants will return every six months over the next three years for physical examinations and to give blood specimens. They also complete a detailed interview and additional questionnaires to collect demographic, psychosocial, behavioral and medical history data, Plankey says.

“The average age of the men in MACS is 58. Most of these men were diagnosed with HIV in the early 1980s when there was much less acceptance of being gay. Many men internalized their ‘self loathing’ — called internalized homophobia — believing and thinking that being gay was pathologic,” Plankey says. “Such feelings, understandably, put gay and bisexual men at greater risk for HIV infection, depression, victimization, substance abuse and reduced access to healthcare, among other issues.”

In May 2013, Plankey was senior author on a study in AIDS and Behavior that found gay and bisexual men “who resolved internalized homophobia had significantly higher odds of positive health outcomes that those who did not.”

“There is much to know about resiliency and vulnerability before an effective intervention that can change health is implemented,” he says. “But it is easy to understand that accepting who you are — loving yourself — increases the chances of healthy behavior.”

“Which is more effective — negative, toxic messages or positive messages that reinforce your value as a human being who chooses to remain healthy?” Plankey asks.

Renee Twombly
GUMC Communications