Inside the Regent Street cinema in Marylebone, London, a group of men and women are in high spirits singing along to a dancing Doris Day. It is a gloomy Wednesday in February but these filmgoers, aged in their 50s to 80s, are determined to enjoy their weekly trip, on this occasion to see the 1955 film Love Me or Leave Me.
As members of the Silver Surfers club, they have one thing in common apart from age and a love of cinema – a diagnosis of HIV.
Simon Horvat-Marcovic, 53, a Silver Surfers regular and former retail manager, was made redundant around the time of his HIV diagnosis in 2015. As someone who lives with depression, he struggles on days when he does not speak to “a single human being”. For him, the club means “you’re not wallowing”.
“Having people understanding how you’re feeling, what’s going on inside your head and who you don’t have to explain yourself to. For me, that’s been brilliant,” he says.
The film club was launched in October 2017 and has 15 members. It is an initiative from the Health, Wealth & Happiness project, a Terrence Higgins Trust (THT) programme offering support to older people with HIV.
With visits to see classics like Gentlemen Prefer Blondes and High Noon, Silver Surfers came about after research by THT into the reality of life in the UK for people growing older with HIV.
At least one in three people accessing care after a diagnosis are aged 50 and over, and they are three times more likely to experience loneliness than the general population, according to the charity. Their social isolation can be compounded by the death of friends during the 80s and 90s, when Aids was at its peak, by no longer being part of the gay scene, and by their reluctance to discuss their diagnosis.
The health of those who are HIV-positive is generally stable thanks to advances in antiretroviral medication, so GPs do not consider them in need of additional support. The result is that their psychosocial needs may be overlooked, a gap in care that can be filled by initiatives like Silver Surfers, according to Clive Blowes, a national coordinator for THT.
“It can be a challenge to bring up the personal in a routine discussion with your GP,” says Blowes. “And if you’re a gay man then doors close to you, like the club scene, once you’re 50-plus.” The film club provides an alternative outlet, where people feel safe to discuss their physical and mental health issues over tea before the screening, he says. One woman in the group is less reliant on counselling services, for example, after joining outings, says Blowes.
For Mary Jones* the film club offers more than the opportunity to enjoy a classic film, have a laugh and chat about films. Despite being diagnosed in 1995, she has never disclosed her HIV status to even close friends because of the stigma and her fear of “being defined by it”. The club provides an essential support network for the 74-year-old, who can compare health notes, share problems such as side-effects of medication and pick up tips without fear of being judged or misunderstood.
Older people with HIV may encounter specific health problems. Ageing may mean the liver is less able to withstand the toxicity of HIV treatment, leading to symptoms such as jaundice. HIV drugs may also interact with other medications, triggering issues such as high blood pressure, which Jones has been experiencing. One club member helped by recommending a new app. “You feed in your information and it tells you exactly what drugs can and can’t be taken together,” says Jones, who contracted the virus from a partner who eventually died from Aids.
“Not even my GP knew about this. They’ve all had HIV training but you get some who are more interested in your condition than others,” she says. Through swapping contact details at the film sessions, Jones has access to peer support when she requires it.
The need for services offering direct health support, such as integrated HIV and cardiology care, for older people is beginning to be recognised by the NHS, according to Tristan Barber, an HIV consultant at Chelsea and Westminster hospital. However, he says there is still a way to go, especially on the psychosocial side, which is why clubs like Silver Surfers are vital. “This is more than just going to see a movie – it gives people a chance to share their stories with others like them and realise their psychological needs,” he says.
David Munns is a clinical nurse specialist for mental health and HIV at the Kobler clinic, part of Chelsea and Westminster hospital. Increasingly, he is getting referrals for over-50s with HIV needing mental health support, partly as a result of people living longer as treatability improves.
Munns has seen the psychological benefit of cinema for patients, including those with HIV, through MediCinema, a scheme set up in 1999 at St Thomas’ hospital offering film screenings to those receiving treatment. He recalls one patient with HIV who was moved to tears after seeing a particular film clip because it reminded him of friends lost to Aids. Now Munns is planning to set up his own cinema support group for people over 50 with HIV.
He says: “It can be a lonely future if you’re getting older, you’ve lost your partner and you’re living with the stigma of HIV. The magic of cinema is you go in as a stranger and come out as friends. It brings you together with others, it gets you talking about and sharing your own experiences.”
* Name has been changed
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