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

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“…Inadequate viral suppression has been linked to inadequate management of the co-morbid conditions of hypertension and diabetes (Monroe, Chander, & Moore, 2011), while HIV-related neurocognitive disorders have been associated with both social and physical factors such as education level, poverty, violence, substance abuse, sleep disorders, cardiovascular disease, hepatitis, and chronic inflammation (Tedaldi, Minniti, & Fischer, 2015). Older PLWH are also susceptible to geriatric syndromes, i.e., clusters of impairments associated with aging such as early frailty, propensity to fall, and cognitive impairment (Calcagno et al, 2015; Chirch, Hasham, & Kuchel, 2014; Greene et al, 2015). Furthermore, for PLWH with other chronic conditions, quality of life has been shown to decrease as disease burden increases (Balderson et al, 2013; Rodriguez-Penney et al, 2013).…”

mentioning

confidence: 99%

Multimorbidity With HIV: Views of Community-Based People Living With HIV and Other Chronic Conditions

Slomka¹,

Prince-Paul²,

Webel³

et al. 2017

Journal of the Association of Nurses in AIDS Care

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People living with HIV (PLWH) experience an increase in chronic conditions with aging, but little is known about experiences of living with multimorbidity with HIV. Because early palliative care services may improve well-being for individuals with multimorbidity, we planned to test an intervention to provide these services to community-dwelling PLWH with other chronic conditions. To tailor our intervention to the target population, we conducted 4 focus groups (n = 22) that elicited health-related needs, experiences, and views regarding palliative and other health services. We identified 4 themes related to patients’ needs and experiences: views of HIV as background to other chronic conditions, challenges managing medications and provider interactions, concerns about coping with future health needs, and persistence of HIV stigma. In addressing multimorbidity with HIV, providers and patients may benefit from enhanced attention to communication when crossing specialty areas and from additional support to decrease stressors associated with HIV stigma.

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confidence: 99%

Multimorbidity With HIV: Views of Community-Based People Living With HIV and Other Chronic Conditions

Slomka¹,

Prince-Paul²,

Webel³

et al. 2017

Journal of the Association of Nurses in AIDS Care

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“…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]. …”

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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

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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.

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“…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

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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.

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HIV and aging

Cited by 11 publications

References 51 publications

Multimorbidity With HIV: Views of Community-Based People Living With HIV and Other Chronic Conditions

Multimorbidity With HIV: Views of Community-Based People Living With HIV and Other Chronic Conditions

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

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