Matlho K., Lebelonyane, L., Driscoll, T., et al. Journal of Social Aspects of HIV/AIDS (2017), 14(1).
This qualitative study examined the attitudes of Botswanan policymakers (n=15: providers and staff of the Ministry of Health and nongovernmental organizations, or NGOs, involved in developing policies) toward HIV-positive adults aged 50 years and older. Interviews revealed that although activism and coordination with civil society organizations often influence government leaders, there are no elderly activists, and NGOs do not focus on older people. Respondents noted that though health care for the elderly is important, there are no geriatric services, nursing homes, or other specialized services available. It is assumed that family will take care of their elders. Yet urban migration leaves the elderly vulnerable as their families move away. Integrated services are needed that link facility- and community-based health services with mental, spiritual, and social health care for this population. Interviewees described the need to either integrate elder care services, or to simply expand siloed HIV care to include older adults. Providers of preventive services overlook the elderly because they assume that they are not sexually active. HIV interventions mainly focus on preventing HIV among younger populations versus preventing HIV or providing services to older adults who are living with a chronic HIV infection. HIV policy should be adapted to reflect the changing epidemic in Botswana and address the needs of the elderly.