Trajectories of social isolation and loneliness among older adults living with HIV who use methamphetamine

Project Summary/Abstract: This application is being submitted in response to PAR-24-092: Multidisciplinary Studies of HIV/AIDS and Aging. There is a high prevalence of methamphetamine and other stimulant use among older adults living with HIV, which places them at high risk for associated adverse outcomes due to co-existing chronic diseases and functional impairments. This population has also experienced a profound loss of their social networks and is at risk for social isolation and loneliness. Additionally, older adults who use drugs experience a high level of stigma related to drug use, treatment, and ageism. All these experiences are also experienced by people living with HIV and would, therefore, be compounded among older adults with HIV who use drugs. The objective of this study is to recruit participants living with HIV who currently use methamphetamine (baseline cohort of n=125) to measure social isolation, loneliness, and intersectional stigma longitudinally and how they may be related to health outcomes. Aim 1 of this study is to characterize trajectories of social isolation and loneliness longitudinally at three time points (baseline, 6 months, and 12 months later) along with changes in methamphetamine use, function, and acute healthcare utilization. Aim 2, through qualitative interviews with a subset of enrolled participants (n=25), will explore patient perspectives on how social isolation and loneliness influence HIV care, substance use, recovery, and treatment and elicit perspectives on strategies to address social connectedness. As an exploratory aim, this study will measure the stigma and discrimination experienced by this population through validated scales. During qualitative interviews, perspectives regarding stigma related to methamphetamine use, HIV, ageism, and other potentially related factors will also be assessed. This research will ultimately inform future interventions to address isolation and disconnection among older adults with HIV who use methamphetamine. This will have additional public health implications for the efficacy of improving substance use treatment and health outcomes among older adults living with HIV.