Strategies adopted by late middle-age and older adults with HIV/AIDS to explain their physical symptoms

Although the attributions individuals make about what causes their physical symptoms are known to influence their care seeking and self-care behaviours, much less is known about the strategies they use to arrive at these attributions. The strategies employed to understand the causes of their symptoms were investigated using in-depth interviews with 100 late middle-age and older adults with HIV/AIDS in New York City. The data revealed that most participants actively sought to explain their symptoms. The explanatory strategies identified included: relying upon illness or medication representations, lay beliefs about the body and ageing, invoking pre-existing vulnerabilities, engaging in lay experimentation, social comparison processes, considering temporal ordering and consulting authoritative sources. While most of them offered a single cause for their symptoms, some offered more complex multi-causal explanations. These findings provide understanding into the reasons why some older adults with HIV/AIDS misattribute symptoms resulting in delay in care or care over-utilisation, suggesting the need for patient education.