Gaps in health and social care services to older adults living with HIV: a qualitative study on the perspectives of older adults and service providers

Wallach, Isabelle; Brotman, Shari

doi:10.15406/ncoaj.2019.06.00179

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…A significant source of uncertainty is how needs will be met if participants become unable to live independently, as previously documented [ 18 ]. Many reject long‐term care or seniors’ housing for fear of HIV stigma and/or homophobia [ 9 , 51 , 52 ]. Although we did not hear many examples, the literature documents experiences of discrimination in healthcare and other institutional settings as common among older PLWH [ 14 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

“We can hardly even do it nowadays. So, what's going to happen in 5 years from now, 10 years from now?” The health and community care and support needs and preferences of older people living with HIV in Ontario, Canada: a qualitative study

Murzin¹,

Racz²,

Behrens³

et al. 2022

J Int AIDS Soc.

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Introduction The population of people living with HIV (PLWH) is ageing consequent to effective treatment and a steady stream of new diagnoses among older adults. PLWH experience a greater burden of age‐related comorbidities and poorer social determinants of health compared to their HIV‐negative peers, yet comprehensive requisites for care and support as PLWH age remain poorly understood. Preferences And Needs for Ageing Care among HIV‐positive Elderly people in Ontario, Canada (PANACHE ON), explored the health and community care and social support needs and preferences of a diverse group of older PLWH (age 60+) and described life course experiences among older PLWH that shape these needs and preferences and whether they are met. Methods PANACHE ON was a qualitative community‐based participatory research study. In‐person focus groups using a semi‐structured interview guide were co‐facilitated by pairs of trained older PLWH from July to October 2019. Purposive sampling bolstered the inclusion of communities disproportionately affected by HIV in Ontario. Descriptive analysis was used to summarize demographic data; participatory data analysis was conducted by a subset of the research team, with transcripts double‐coded and analysed using NVIVO 12 Plus. Results A total of 73 PLWH participated, 66% identified as men. The mean age was 64 years (range 55–77) and median time living with HIV was 23 years (range 2–37). The current and anticipated needs of older PLWH, many of which were only partially met, included necessities such as food and housing, mobility and sensory aids, in‐home support, social and emotional support, transportation and information. Three experiences—trauma, stigma and uncertainty—intersected in the lives of many of our participants, shaping their needs for care and support, and impacting the ease with which these needs were met. Conclusions Unmet health and social needs and limited control over the availability and accessibility of ageing‐related care and support due to resource constraints or reduced capacity for self‐advocacy results in anxiety about the future among older PLWH, despite their well‐developed coping strategies and experience navigating systems of care. These study findings will inform the development of the first national needs assessment of older PLWH in Canada.

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Section: Discussionmentioning

confidence: 99%

“We can hardly even do it nowadays. So, what's going to happen in 5 years from now, 10 years from now?” The health and community care and support needs and preferences of older people living with HIV in Ontario, Canada: a qualitative study

Murzin¹,

Racz²,

Behrens³

et al. 2022

J Int AIDS Soc.

View full text Add to dashboard Cite

show abstract

“…Previous studies have explored the stigma and marginalization that can be found in non-specialist services [ 17 ]. Difficulties in transitioning between the different services and gaps in these services for PLWH have likewise been found [ 3 , 19 ], meaning that PLWH have to balance who would best meet their needs and help them maintain their QoL while having to cope with the possibility of a negative experience.…”

Section: Discussionmentioning

confidence: 99%

An exploration of the quality of life of people living with HIV in Greece: Challenges and opportunities

et al. 2022

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Objective Improving the quality of life (QoL) of people living with HIV (PLWH) has been proposed as a new priority in HIV care. The objective of this cross-sectional, qualitative study was to explore the perspectives of PLWH in Greece regarding their QoL. Design Twenty-four semi-structured interviews were conducted with PLWH receiving care across six HIV clinics in Greece. The thematic analysis of the transcribed interviews resulted in four themes and eleven subthemes. Results First, fear of repercussions (e.g., stigmatization) makes PLWH reluctant to disclose their diagnosis in public settings or disclose accounting for factors like the confidant’s discretion. Second, participants are challenged by HIV’s unique biopsychosocial facets (e.g., uncertainty about symptoms) and fear for the future (e.g., a confidant revealing their HIV status without consent). Third, support received by specialist services is satisfactory in contrast to non-HIV specialist services, where significant improvements are needed to reduce stigmatization. Finally, the experiences of PLWH include contrasting elements of post-traumatic growth and an inability to accept their seropositivity (e.g., avoiding social interactions). Conclusions Empowering PLWH in these QoL areas is greatly needed. Increasing the life expectancy of PLWH is only the initial step; their QoL needs to be secured as the next priority in HIV care.

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“…Older adults also tend to not access social services designed for the HIV-infected population because of their own assumption that these programs are created only for younger individuals [ 22 ]. Consequently, HIV scholars have urged for a health and social care system where knowledge and communication about geriatric HIV care are encouraged amongst advocates who work directly with this population, such as geriatric healthcare workers [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding geriatric models of care for older adults living with HIV: a scoping review and qualitative analysis

et al. 2023

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Background Advances in Human Immunodeficiency Virus (HIV) treatment have reduced mortality rates and consequently increased the number of individuals with HIV living into older age. Despite this, people aged 50 years and older have been left behind in recent HIV treatment and prevention campaigns, and a gold-standard model of care for this population has not yet been defined. Developing evidence-based geriatric HIV models of care can support an accessible, equitable, and sustainable HIV health care system that ensures older adults have access to care that meets their needs now and in the future. Methods Guided by Arksey & O’Malley (2005)’s methodological framework, a scoping review was conducted to determine the key components of, identify gaps in the literature about, and provide recommendations for future research into geriatric models of care for individuals with HIV. Five databases and the grey literature were systematically searched. The titles, abstracts and full texts of the search results were screened independently in duplicate. Data were analyzed using a qualitative case study and key component analysis approach to identify necessary model components. Results 5702 studies underwent title and abstract screening, with 154 entering full-text review. 13 peer-reviewed and 0 grey literature sources were included. Most articles were from North America. We identified three primary model of care components that may improve the successful delivery of geriatric care to people living with HIV: Collaboration and Integration; Organization of Geriatric Care; and Support for Holistic Care. Most articles included some aspects of all three components. Conclusion To provide effective geriatric care to older persons living with HIV, health services and systems are encouraged to use an evidence-based framework and should consider incorporating the distinct model of care characteristics that we have identified in the literature. However, there is limited data about models in developing countries and long-term care settings, and limited knowledge of the role of family, friends and peers in supporting the geriatric care of individuals living with HIV. Future evaluative research is encouraged to determine the impact of optimal components of geriatric models of care on patient outcomes.

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Gaps in health and social care services to older adults living with HIV: a qualitative study on the perspectives of older adults and service providers

Cited by 3 publications

References 26 publications

“We can hardly even do it nowadays. So, what's going to happen in 5 years from now, 10 years from now?” The health and community care and support needs and preferences of older people living with HIV in Ontario, Canada: a qualitative study

“We can hardly even do it nowadays. So, what's going to happen in 5 years from now, 10 years from now?” The health and community care and support needs and preferences of older people living with HIV in Ontario, Canada: a qualitative study

An exploration of the quality of life of people living with HIV in Greece: Challenges and opportunities

Understanding geriatric models of care for older adults living with HIV: a scoping review and qualitative analysis

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