{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T15:54:29Z","timestamp":1776959669313,"version":"3.51.4"},"reference-count":25,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,3,21]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the episodic disability experiences of older women living with HIV over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative longitudinal study, conducting semistructured in-depth interviews on four occasions over a 20-month time frame. Inductive thematic analyses were conducted cross-sectionally and longitudinally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Participants were recruited from HIV community organisations in Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>10 women aged 50 years or older living with HIV for more than 6 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two major themes related to the episodic nature of the women\u2019s disability. Women were living with multiple and complex sources of uncertainty over time including: unpredictable health challenges, worrying about cognition, unreliable weather, fearing stigma and the effects of disclosure, maintaining housing and adequate finances, and fulfilling gendered and family roles. Women describe strategies to deal with uncertainty over time including withdrawing and limiting activities and participation and engaging in meaningful activities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This longitudinal study highlighted the disabling effects of HIV over time in which unpredictable fluctuations in illness and health resulted in uncertainty and worrying about the future. Environmental factors, such as stigma and weather, may put older women living with HIV at a greater risk for social isolation. Strategies to promote dealing with uncertainty and building resilience are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-021507","type":"journal-article","created":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T12:17:41Z","timestamp":1524226661000},"page":"e021507","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Qualitative longitudinal study of episodic disability experiences of older women living with HIV in Ontario, Canada"],"prefix":"10.1136","volume":"8","author":[{"given":"Patricia","family":"Solomon","sequence":"first","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly K","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Nixon","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lori","family":"Letts","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Baxter","sequence":"additional","affiliation":[{"name":"Community HIV Volunteer, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Gervais","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,4,20]]},"reference":[{"key":"2025121300312505000_8.4.e021507.1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(17)30066-8"},{"key":"2025121300312505000_8.4.e021507.2","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1093\/cid\/cix253","article-title":"Disability Among Middle-Aged and Older Persons With Human Immunodeficiency Virus Infection","volume":"65","author":"Johs","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2025121300312505000_8.4.e021507.3","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-6-76"},{"key":"2025121300312505000_8.4.e021507.4","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/1758-2652-12-30","article-title":"Putting episodic disability into context: a qualitative study exploring factors that influence disability experienced by adults living with HIV\/AIDS","volume":"12","author":"O\u2019Brien","year":"2009","journal-title":"J Int AIDS Soc"},{"key":"2025121300312505000_8.4.e021507.5","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1080\/08964289.2014.893983","article-title":"HIV\/AIDS in older women: unique challenges, unmet needs","volume":"40","author":"Durvasula","year":"2014","journal-title":"Behav Med"},{"key":"2025121300312505000_8.4.e021507.6","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s11904-016-0338-4","article-title":"HIV and Aging Research in Women: An Overview","volume":"13","author":"Stoff","year":"2016","journal-title":"Curr HIV\/AIDS Rep"},{"key":"2025121300312505000_8.4.e021507.7","doi-asserted-by":"publisher","DOI":"10.1177\/0008417413501153"},{"key":"2025121300312505000_8.4.e021507.8","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2014.0024"},{"key":"2025121300312505000_8.4.e021507.9","doi-asserted-by":"publisher","DOI":"10.1177\/0193945905275973"},{"key":"2025121300312505000_8.4.e021507.10","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1080\/13607863.2014.917608","article-title":"Reflections on living with HIV over time: exploring the perspective of HIV-infected women over 50","volume":"19","author":"Psaros","year":"2015","journal-title":"Aging Ment Health"},{"key":"2025121300312505000_8.4.e021507.11","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s11904-016-0340-x","article-title":"Aging and neurocognitive functioning in hiv-infected women: a review of the literature involving the women\u2019s interagency HIV study","volume":"13","author":"Vance","year":"2016","journal-title":"Curr HIV\/AIDS Rep"},{"key":"2025121300312505000_8.4.e021507.12","unstructured":"NVivo qualitative data analysis Software; QSR International Pty Ltd. 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