The newly established Seasoned Survivors Senior Center in Fort Worth, Texas, supports HIV-positive older adults, testament to the fact that what once was a deadly and life-shortening condition has entered the category of chronic health condition.

And the center plays an essential role in supporting a population that faces more than the usual barriers to aging with dignity.

What is the history of the Seasoned Survivors Center?

AIDS Outreach Center (AOC) in Fort Worth, Texas, began as a grassroots organization responding to the HIV epidemic. Since its inception, AOC has been a leader in North Texas in the fight against HIV. Annually, 42 staff members provide services and education to over 2,000 people living with HIV and prevention services to over 3,500 people in the community. In 1986, the focus of the AOC was to support death with dignity.

As improved treatments have helped people to live longer, AOC’s focus shifted to prevention and supporting life with HIV. The center’s core services today include:

• Medical transportation
• Care coordination
• Outreach
• Peer advocates, patient navigators, and case managers
• Housing and utility assistance
• Emergency assistance​
• Nutrition support, including a food pantry and nutrition counseling​
• Dental clinic​
• Mental health counseling​
• Insurance assistance

Additionally, AOC provides ​community health HIV Testing, STI testing & treatment, PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) medications.

Funded primarily by HRSA Ryan White funding provided through the County of Tarrant, AOC serves people 18 and older and has dedicated youth services and senior services—something that would not have been contemplated in 1986 when a diagnosis of HIV was, essentially, a death sentence.

Today there are a growing number of older adults living with HIV—those who were diagnosed in their younger years and thousands who are newly infected every year. AOC established the Seasoned Survivors support group to address the unique needs of older adults who are more likely to experience chronic illness and less likely to access traditional supports. The group was very successful, with 636 people in their database already who are age 55+ with another 400 people who are 45-54.

Support group participants expressed a need for more: a safe and welcoming place where they could learn, play games, go on outings, get health care information, socialize with peers, exercise, enjoy arts and crafts, and have the freedom to just be themselves.

The American Rescue Plan Act provided a unique funding opportunity for AOC. They submitted two grant applications to the county, one that was focused on the unique needs of women with HIV, considering heterosexual black women are one of the fastest growing populations of new infections, and the other to support older adults. They were told that they could be funded for only one, and they opted to move forward with a plan to create a senior center for older adults with HIV, calling it the Seasoned Survivors Senior Center.

They were awarded $1 million for a 2.5-year project that started in September 2022. The large grant is aligned with the need in Tarrant County where the rate of new infections is higher than in the rest of the state and the rest of the country.¹  The populations more heavily impacted by HIV include heterosexual black women, people experiencing homelessness, people using injectable substances, and younger males—mostly undocumented—who are engaged in sex work. And it includes older adults who are less likely to be tested and whose symptoms may be mistaken for other conditions associated with aging.

A senior center: The perfect support model for HIV-positive older adults

Leading the Seasoned Survivors Senior Center project is Michelle Pantaleo, a gerontologist with deep experience in senior center operations. As the long-time leader of a senior center in New England before making a move to Texas, she was hired at AOC in September 2021 to lead their Client Services Department and was able to quickly assess and respond to the needs of the older adults who, already dealing with the isolation of their HIV diagnoses, were struggling during COVID. She also knew the perfect model for expanding those supports and services was through a senior center.

The most challenging part of the project: locating space. They worked with four real estate agents on the search for a building that would provide accessibility, kitchen space, adequate parking, and room to hold programs and activities. When no commercial rental space was available, they were offered a renovated two-bedroom house that had an outbuilding suitable for programs. They accepted.

The space is not ideal. There is a kitchen area, open space for about 30 people (without tables), thresholds that are challenging for people with mobility challenges, and limited on-street parking. But they have made it work and opened the doors on Jan. 7, 2023, with two full time staff—a coordinator and assistant. They also started with that core group of people from the support group. And they love it! A participant is waiting at the door at 8:30 every morning, thrilled to have a place to go.

What happens at the Seasoned Survivors Senior Center?

The programs and activities at the Seasoned Survivors Senior Center are just getting started. But they are typical of many senior centers. Programming is aligned to address social determinants of health and include diversified recreational, educational, nutritional, health, and social activities and programs to meet the needs, interests and abilities of participants and enhance their quality of life and well-being. They provide case management, benefits access, and emergency assistance to address economic stability. 

A nurse practitioner provides wellness classes. There are exercise classes, a nutritionist offers monthly classes with topics like juicing, air fryers, and smoothie bars, and social and educational programs include coffee talks, support groups, recreation and arts programs, and group outings in the community. The center offers evidence-based programs to address chronic disease and falls prevention.

The center’s approach to programming is illustrated in the slogan on a recent flyer: “Be fit, be active, be social, be informed, be you.”

While the outlook for people living with HIV is dramatically different than it was when some of these older adults were younger—and this is a generation that watched their community die—incredible trauma and stigma are attached to an HIV diagnosis. The Seasoned Survivors Center offers many of the typical senior center supports and activities while importantly addressing the ways that pervasive stigma affects HIV-positive older adults.

Pantaleo recently related recent AOC client stories of teenagers who were not allowed to sit at the family dining table and one young woman whose family would not let her access lifesaving medication out of shame. Trauma-informed care is at the core of AOC and the senior center. Many of the people they serve have been ostracized by their community and by their families. The senior center provides a place where everyone can be themselves, where acceptance is unconditional, where they can build community, and where they can get the support they need.

Living with HIV presents challenges, no matter the person’s age. But older people living with HIV may face different issues than their younger counterparts, including increased social isolation, which was compounded by the COVID-19 pandemic.

What’s next for the Seasoned Survivors Senior Center?

The center has only been open a few months, and they will continue to add programs and engage more people. But they are already feeling the constraints of their small facility. There simply isn’t enough space.

They are also very aware of the limitations of their American Rescue Plan Act grant and its end date. They are committed, though, to using this opportunity to demonstrate the proof of concept and to establish the value and impact of this senior center. As they improve the lives of hundreds of older adults, they will also serve as an exemplar for the rest of the country in raising awareness about the need to support older adults who are living with HIV.

Still not a member of the National Institute for Senior Centers? Join today, membership is free.

If your center has engaged in a recent study or assessment, we’d love to hear about it. And if you haven't already, we'd encourage you to join the National Institute of Senior Centers (NISC). Free to all senior centers (and their personnel), NISC supports senior centers with best practices and innovations in programming, as well as networking and training opportunities. Ask for help, leverage NISC resources, or share your successes like the Seasoned Survivors Center. Find out how you can become a NISC Affiliate today.

Photo courtesy Seasoned Survivors Senior Center

Sources

1. AIDSVu. Local Data: Tarrant County, TX. Rates of Persons Living with HIV, 2020. Found on the internet at https://aidsvu.org/local-data/united-states/south/texas/tarrant-county/