HIV and aging

Chirch, Lisa M.; Hasham, Mohamed; Kuchel, George A.

doi:10.1097/coh.0000000000000074

Cited by 11 publications

(5 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinics differed with various initiatives and/or resources when comparing a hospital-based ID clinic to an academic community clinic moving toward patient-centered medical home status, which is why we clustered our analyses by provider to incorporate the practice environment. We conclude that the high-quality indicator rates suggests that many approaches are feasible, especially because HIV care is increasingly streamlined and because many settings are addressing HIV treatment scale up and integration of HIV and chronic disease management [1, 2, 5]. …”

Section: Discussionmentioning

confidence: 99%

“…The human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic has transitioned over the past 2 decades, from a focus on treatment of opportunistic infections and management of complex antiretroviral therapy (ART) regimens to a chronic disease model for care of patients with near-normal life expectancy [1–3] and an increased focus on noncommunicable disease prevention and management while maintaining high-quality HIV care [1, 2, 4]. …”

mentioning

confidence: 99%

See 1 more Smart Citation

Human Immunodeficiency Virus (HIV) Quality Indicators Are Similar Across HIV Care Delivery Models

Rhodes

Chang

Regan

et al. 2017

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background.There are limited data on human immunodeficiency virus (HIV) quality indicators according to model of HIV care delivery. Comparing HIV quality indicators by HIV care model could help inform best practices because patients achieving higher levels of quality indicators may have a mortality benefit.Methods.Using the Partners HIV Cohort, we categorized 1565 patients into 3 HIV care models: infectious disease provider only (ID), generalist only (generalist), or infectious disease provider and generalist (ID plus generalist). We examined 12 HIV quality indicators used by 5 major medical and quality associations and grouped them into 4 domains: process, screening, immunization, and HIV management. We used generalized estimating equations to account for most common provider and multivariable analyses adjusted for prespecified covariates to compare composite rates of HIV quality indicator completion.Results.We found significant differences between HIV care models, with the ID plus generalists group achieving significantly higher quality measures than the ID group in HIV management (94.4% vs 91.7%, P = .03) and higher quality measures than generalists in immunization (87.8% vs 80.6%, P = .03) in multivariable adjusted analyses. All models achieved rates that equaled or surpassed previously reported quality indicator rates. The absolute differences between groups were small and ranged from 2% to 7%.Conclusions.Our results suggest that multiple HIV care models are effective with respect to HIV quality metrics. Factors to consider when determining HIV care model include healthcare setting, feasibility, and physician and patient preference.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Human Immunodeficiency Virus (HIV) Quality Indicators Are Similar Across HIV Care Delivery Models

Rhodes

Chang

Regan

et al. 2017

Open Forum Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…Combined antiretroviral therapy has remarkably reduced AIDS-related morbidity and mortality and enabled HIV infection to be managed as a chronic disease [1][2][3]. However, in this prolonged survival scenario people living with HIV (PLH) need to cope with long-term outcomes of chronic HIV infection, including lipodystrophy, diabetes and consequent increased cardiovascular risk [4].…”

Section: Introductionmentioning

confidence: 99%

Incorporating physical activity in the comprehensive care of people living with HIV starting antiretroviral therapy: Insights from a specialized care setting in São Paulo, Brazil

Santos

Picone

et al. 2021

PLoS ONE

View full text Add to dashboard Cite

Background Managing HIV infection as a chronic condition includes encouraging adoption of healthy behaviors and promotion of physical activity (PA). However, people living with HIV (PLH) are often under social and programmatic vulnerability that may compromise behavior change. Understanding such barriers is crucial for successful incorporation of PA in their comprehensive care. Methods and findings In this study, we describe PA, energy intake from diet, and anthropometry of a cohort of PLH starting antiretroviral therapy (ART) at a Brazilian reference clinic, report how PA was addressed in routine care and investigate association between PA, energy intake and psychosocial constructs that may facilitate PA (social support and self-efficacy for PA). Among 61 PLH (86.9% males, mean age = 32.5 years) anthropometry was normal, but 47.5% reported PA below recommendations. Despite presenting high social support scores, family encouragement for PA was low, and self-efficacy classified as medium. Chart reviews yielded infrequent reports concerning PA. After adjusting for gender and age, we found a negative association between energy intake from diet and self-efficacy, but none between PA and energy intake or between PA and psychosocial constructs. Conclusions We conclude that patients in our cohort were insufficiently active when starting ART, and that PA was poorly addressed by caretakers in routine HIV care. Nevertheless, social support and self-efficacy scores suggest potential for behavioral change. Caregivers should therefore start considering patients’ vulnerabilities and establishing strategies to help them overcome barriers to incorporate PA in their comprehensive care effectively.

show abstract

“…PLWHA also have higher incidence of specific NCDs, including non-AIDS defining malignancies[7, 8], and cardiovascular disease[9–14], and have different indications for screening for some NCDs[15]. The changing nature of comorbidities in HIV has necessitated development of HIV care models that address chronic disease management[16, 17], yet there are limited data to help determine the optimal care model for this patient population[18]. …”

Section: Introductionmentioning

confidence: 99%

Non-Communicable Disease Preventive Screening by HIV Care Model

et al. 2017

View full text Add to dashboard Cite

ImportanceThe Human Immunodeficiency Virus (HIV) epidemic has evolved, with an increasing non-communicable disease (NCD) burden emerging and need for long-term management, yet there are limited data to help delineate the optimal care model to screen for NCDs for this patient population.ObjectiveThe primary aim was to compare rates of NCD preventive screening in persons living with HIV/AIDS (PLWHA) by type of HIV care model, focusing on metabolic/cardiovascular disease (CVD) and cancer screening. We hypothesized that primary care models that included generalists would have higher preventive screening rates.DesignProspective observational cohort study.SettingPartners HealthCare System (PHS) encompassing Brigham & Women’s Hospital, Massachusetts General Hospital, and affiliated community health centers.ParticipantsPLWHA age >18 engaged in active primary care at PHS.ExposureHIV care model categorized as infectious disease (ID) providers only, generalist providers only, or ID plus generalist providers.Main Outcome(s) and Measures(s)Odds of screening for metabolic/CVD outcomes including hypertension (HTN), obesity, hyperlipidemia (HL), and diabetes (DM) and cancer including colorectal cancer (CRC), cervical cancer, and breast cancer.ResultsIn a cohort of 1565 PLWHA, distribution by HIV care model was 875 ID (56%), 90 generalists (6%), and 600 ID plus generalists (38%). Patients in the generalist group had lower odds of viral suppression but similar CD4 counts and ART exposure as compared with ID and ID plus generalist groups. In analyses adjusting for sociodemographic and clinical covariates and clustering within provider, there were no significant differences in metabolic/CVD or cancer screening rates among the three HIV care models.ConclusionsThere were no notable differences in metabolic/CVD or cancer screening rates by HIV care model after adjusting for sociodemographic and clinical factors. These findings suggest that HIV patients receive similar preventive health care for NCDs independent of HIV care model.

show abstract

HIV and aging

Cited by 11 publications

References 51 publications

Human Immunodeficiency Virus (HIV) Quality Indicators Are Similar Across HIV Care Delivery Models

Human Immunodeficiency Virus (HIV) Quality Indicators Are Similar Across HIV Care Delivery Models

Incorporating physical activity in the comprehensive care of people living with HIV starting antiretroviral therapy: Insights from a specialized care setting in São Paulo, Brazil

Non-Communicable Disease Preventive Screening by HIV Care Model

Contact Info

Product

Resources

About