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Omar Karlsson . Photo

Omar Karlsson

Postdoctoral fellow

Omar Karlsson . Photo

Antiretroviral therapy coverage associated with increased co-residence between older and working-age adults in Africa

Author

  • Jan-Walter De Neve
  • Omar Karlsson
  • Lelani Coetzee
  • Henning Schröder
  • S V Subramanian
  • Till Bärnighausen
  • Sebastian Vollmer

Summary, in English

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.

Department/s

  • Centre for Economic Demography

Publishing year

2018-09-10

Language

English

Pages

2051-2057

Publication/Series

AIDS

Volume

32

Issue

14

Document type

Journal article

Publisher

Lippincott Williams & Wilkins

Topic

  • Public Health, Global Health, Social Medicine and Epidemiology

Status

Published

ISBN/ISSN/Other

  • ISSN: 1473-5571