Universität zu Köln

De Neve, Jan-Walter ORCID: 0000-0003-0090-8249, Karlsson, Omar, Coetzee, Lelani, Schroeder, Henning, Subramanian, S. V., Baernighausen, Till and Vollmer, Sebastian ORCID: 0000-0002-7863-0462 (2018). Antiretroviral therapy coverage associated with increased co-residence between older and working-age adults in Africa. Aids, 32 (14). S. 2051 - 2058. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-5571

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Abstract

Objectives: To determine whether national antiretroviral therapy (ART) coverage is associated with changes in the living arrangements of older adults. Design: Retrospective analysis using 103 nationally representative surveys from 28 African countries between 1991 and 2015. Methods: The sample consisted of individuals aged at least 60 years. We investigated how three measures of living arrangements of older adults have changed with ART coverage: the number of older individuals living without working-age adults, the number of older individuals living with only dependent children (i.e. 'missing generation' households), and the number of working-age adults per household where an older individual lives. Results: Our sample consisted of 297 331 older adults. An increase in ART coverage of 1% was associated with a 0.7 percentage point reduction (P < 0.001) in the probability of an older adult living without working-age adult and a 0.2 percentage point reduction (P = 0.005) in the probability of an older adult living in a 'missing generation' household. Increases in ART coverage were also associated with more working-age adults in households with at least one older adult. In our study countries, representing 75% (749 million) of the sub-Saharan population, an additional 103 000-358 000 older adults could be living with working-age adults as a result of increased ART coverage (1%). Conclusion: The scale-up of ART has likely led to substantial increases in co-residence between older and working-age adults in Africa. Returns to investments in HIV treatment will be too low, if the social benefits from these changes in living arrangements of older adults are not taken into account. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code De Neve, Jan-Walter UNSPECIFIED orcid.org/0000-0003-0090-8249 UNSPECIFIED Karlsson, Omar UNSPECIFIED UNSPECIFIED UNSPECIFIED Coetzee, Lelani UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Henning UNSPECIFIED UNSPECIFIED UNSPECIFIED Subramanian, S. V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Baernighausen, Till UNSPECIFIED UNSPECIFIED UNSPECIFIED Vollmer, Sebastian UNSPECIFIED orcid.org/0000-0002-7863-0462 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-173037
DOI:	10.1097/QAD.0000000000001917
Journal or Publication Title:	Aids
Volume:	32
Number:	14
Page Range:	S. 2051 - 2058
Date:	2018
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-5571
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SUB-SAHARAN AFRICA; INTERGENERATIONAL TRANSFERS; SOUTH-AFRICA; SCALE-UP; IMPACT; HIV/AIDS; HEALTH; SURVIVAL; RISK Multiple languages Immunology; Infectious Diseases; Virology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17303