Formative research to understand the impact of the HIV/AIDS epidemic on the elderly in India: Challenges with study design

The AIDS epidemic is one of the biggest public health challenges today. A lot of emphasis is given on the reproductive age group (15 to 49) and vulnerable children while older people are more or less neglected in programs for HIV /AIDS. Anecdotal evidence supports the fact that older people are increasingly being infected and affected by the AIDS epidemic across the world and in India. Elderly also bear the brunt as primary care givers for children, especially grand children and are coping with stress, poverty and discrimination in the community. Various challenges were faced while designing a formative research study to assess the impact of HIV/AIDS on the elderly in India. These are explained in the paper and range from convincing policy makers, program planners, funding agencies of the need for such information and programs as well as building partnerships at the grass roots level. The objective was to build a strong evidence base for programing for elderly people and HIV/AIDS in a resource constrained setting. The paper also describes the study design tailored to the developing country setting using qualitative and quantitative methods. Some of the recommendations from this process include the urgent need to understand the epidemic as it relates to the elderly population, to design relevant messages (prevention, treatment, care and support)for the elderly, and to strengthen linkages in the community to lessen impact of the epidemic on this sub set of population.