William B. Disch

Individual, contextual, and social network factors affecting exposure to HIV/AIDS risk among older residents living in low-income senior housing complexes.

Summary: This study examines the influence of individual, contextual (building location and characteristics), and social network characteristics on HIV prevalence and risk behavior among people older than 50 years of age living in low‐income senior housing in two cities, Hartford, Connecticut and Chicago, Illinois. The authors’ study focuses on older residents of six buildings located in impoverished neighborhoods with high rates of HIV transmission through injection drug use and unprotected sexual activity, including the exchange of sex for drugs and money. The article is organized into three sections. First, the authors explore the HIV prevalence, distribution, and risk behaviors that may contribute to new infections among the buildings’ older residents in general. These practices include unprotected sexual intercourse, sex with commercial sex workers, casual or multiple partners, regular use of alcohol and/or illicit drugs, and other high‐risk activities that expose older residents to HIV, sexually transmitted diseases, and other negative health consequences. Next, the authors examine the relationship between building and neighborhood characteristics, the internal social organization of buildings, and the risk behaviors of individual residents by building residency. Finally, the authors use a social network analysis to identify possible entry points and transmission routes for HIV infection through drug and sexual exchanges between and among building residents and visitors. This approach also reveals variations in building structures that may facilitate the diffusion of HIV prevention efforts.

Mental health in senior housing: racial/ethnic patterns and correlates of major depressive disorder

Objectives: Mental health problems are associated with disability, overuse of medical care, higher rates of mortality and suicide as well as personal suffering for older adults. Residents of urban, low-income senior housing may face increased risk of a variety of mental health problems, including depression. This study identified the prevalence of multiple mental health problems in older residents of low-income senior housing and explored correlates of major depressive disorder for the two largest ethnic groups: black and Latino. Method: In-person diagnostic interviews identified rates of mental illness in a sample of 635 residents of 13 low-income senior housing buildings in a medium-sized northeastern city. Applying Georges Social Antecedent Model of Depression, logistic regression analyses identified shared and unique correlates of depression for Latino and black participants. Results: This population had high rates of major depressive disorder (26%), generalized anxiety disorder (12%) and other mental health problems that varied significantly by ethnic and racial group. Separate multivariate models for Latino and black people showed that younger age, more chronic conditions and social distress were related to major depressive disorder for both ethnic groups. Perceived environmental stress, shorter tenure in the building, poorer perceived health, higher life stress and fewer leisure activities were associated with depression for Latinos only. Conclusion: Mental health screening and treatment services are needed in senior housing to address these high rates of mental illness. Unique constellations of correlates of depression for different ethnic groups underscore a need for culturally competent approaches to identification and treatment.

Understanding Low-Income, Minority Older Adult Self-Perceptions of HIV Risk

&NA; The number of people ages 50 or older living with HIV in the United States is increasing. Yet, few older adults see themselves at risk of infection. This study examines the heuristic reasoning that low income, minority adults, ages 50 or older use in calculating the likelihood of infection. The data are drawn from face‐to‐face interviews with a sample of 134 African American and Latino residents, ages 50 to 86, living in low‐income housing in Chicago, Illinois, and Hartford, Connecticut. Results show that nearly half of the studys participants thought themselves to be at some level of risk for HIV. In self‐assessing their risk, they relied on seven heuristic categories: self‐imperilment, social imperilment, fate, incidental contact, situational safety, medical iatrogenesis, and self‐protection. These findings extend our understanding of how individuals make sense of their likelihood of experiencing a major health threat and provide insight into more effective HIV prevention programming for older adults.

Anxious depression among Puerto Rican and African-American older adults

Objectives: To determine racial/ethnic differences in the prevalence and impact of anxious depression (i.e. major depressive disorder, MDD, occurring concomitant with generalized anxiety symptoms) among older adults. Method: Interviews were conducted with 218 Puerto Rican and 206 African American older (age ≥60) urban senior housing residents. Data were collected on diagnostic status, depression severity and psychosocial functioning. Results: Results indicated a higher prevalence of MDD and anxious depression among Puerto Rican participants. Anxious depression was associated with more severe ratings of distress and suicidality compared with MDD alone, and the impact of depression and anxiety was most pronounced for the Puerto Rican participants. Puerto Rican participants also reported poorer subjective health and more substantial disability; however, these effects were independent of depression or anxiety status. Conclusions: Anxious depression is common among older ethnic minority adults and the impact of these symptoms differs by race/ethnicity. These results highlight the importance of conducting culturally sensitive assessments of depression and anxiety among older adults.

Assessing human immunodeficiency virus (HIV) risk among older urban adults: a model for community-based research partnership.

Summary: Community-based research brings together researchers and community members as partners to conduct research of mutual concern. This article describes the components necessary to implement a successful research partnership, taking as an example a study of human immunodeficiency virus (HIV) risk among residents of senior housing sites in two North American cities. The article describes important aspects of building and sustaining partnerships, the methods implemented to conduct research on sensitive topics, share resources, disseminate results and collaborate on programs and interventions to benefit the health and well-being of older adults.

Mentor Service Themes Emergent in a Holistic, Undergraduate Peer-Mentoring Experience

Little research has focused carefully on the means by which peer mentors foster development in undergraduate protégés. Two faculty members developed a holistic, peer-mentoring project in which 26 upperclassmen mentored 74 underclassmen at a midsize, 4-year institution. Mentor journal notes, open-ended protégé responses, and participant observations were analyzed using a grounded theory approach, resulting in the emergence of 7 themes of mentor service activity. Findings expand our understanding of the mechanics through which peer mentors successfully serve and foster the development of early undergraduates in making the transition to college. Results can be used to facilitate the transition of academically underprepared undergraduates, who have the lowest retention rates.