Subjective Age and Health Care Avoidance Among Aging Men Living With or Without HIV

Introduction Negative aging perceptions have been shown to influence one’s health care–seeking behaviors; this relationship has not been studied among middle-aged and aging adults living with HIV. The current study uses data from the Multicenter AIDS Cohort Study (MACS) to investigate the association between subjective age and health care avoidance. Objective To examine the hypothesis that adults living with HIV who perceive themselves as older, after adjustment for covariates, would be more likely to avoid care than their HIV-negative counterparts who perceive themselves as older. Methods The MACS is a prospective study of more than 7000 sexual minority men living with and without HIV from 4 metropolitan US areas. The Understanding Patterns of Healthy Aging in Men Who Have Sex With Men sub-study of the MACS was conducted from April 2016 to March 2019. Current analyses use cross-sectional data on 1118 participants from this sub-study from October 2016 to March 2017. Logistic regression was used to produce odds ratios and 95% CIs examining the association between subjective age and health care avoidance. Covariates included age, HIV status, race and ethnicity, education, and comorbid conditions. Further analyses were conducted among persons living with HIV, which included CD4 counts and viral load detection as covariates. Results In the full sample and sample of people living with HIV, after adjustment for covariates, there was a positive association between older subjective age and health care avoidance and a negative association between younger subjective age and health care avoidance, albeit both not statistically significant. Living with HIV was positively associated with health care avoidance, but not statistically significant. Conclusions Future studies with larger sample sizes are needed to elucidate the significance of subjective age and health care avoidance. Aside from the pivotal role of health care avoidance, the field of HIV and aging may benefit from identifying other psychological, physiological, and behavioral mechanisms by which perceptions of aging influence health.