Gender Differences in Social Support Vary by Environment among Older People with HIV in South Africa and Uganda

Abstract

Abstract Background and Objectives Sub-Saharan Africa is home to 3.7 million older adults living with HIV, who experience high rates of comorbid conditions. Formal services other than HIV clinical care are largely unavailable. Overall, women are the mainstay of informal social support networks, and older women with HIV may face burdens due to family caregiving expectations. Thus, it is important to understand the extent of informal support provided to older adults living with HIV, and how this is affected by gender. Research Design and Methods We examined differences in social networks, needs, social support and caregiving, and perceptions of support adequacy among women and men aged 50 and older living with HIV in Uganda (n = 101) and South Africa (n = 108), mostly rural and suburban populations, respectively. We used multiple regression to determine whether there was an association between gender and the amount of social support received and whether that varied by research site. Results Men were more likely than women to receive support from a partner. Women were more likely to live with offspring, both providing and receiving care. In South Africa but not Uganda, women received more help from family than men did. There was no gender difference in help from friends, but it was more common in Uganda. Living alone was strongly associated with less family help and more help from friends. Discussion and Implications Older women with HIV in sub-Saharan Africa tend to be more heavily involved in social support exchanges—both providing and receiving care—than their male peers, but place matters. Interdependence is high in rural Uganda, where formal services are scarce and needs exceed resources. Given the projected growth in this population, stronger formal supports are needed for communities and older people with HIV, especially those who live alone.