People aging with HIV – protecting a population vulnerable to effects of COVID-19 and its control measures

Schmalzle, Sarah; Viviano, Nicole; Mohanty, Kareshma; Palmeiro, Robyn M.; Hoffmann, Jennifer; Sheth-Pandit, Neha; Gruber‐Baldini, Ann L.; Stafford, Kristen A.

doi:10.1080/09540121.2021.2020208

Cited by 6 publications

(41 citation statements)

References 32 publications

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“…Ten of these models ( n = 10/13, 77%) occurred in‐person at outpatient settings. Most studies ( n = 9/11, 82%) described an in‐person geriatric consultation service located within an existing HIV clinic [14–16, 20, 43–47], although one ( n = 1/11, 9%) detailed a community outreach service delivered in people's homes [48], and two ( n = 2/11, 18%) included components delivered in an online or telemedicine format [15, 49]. Almost all models of care ( n = 11/14, 79%) incorporated a multidisciplinary team [14–16, 20, 43–49] into the delivery of care.…”

Section: Resultsmentioning

confidence: 99%

Exploring implementation considerations for geriatric‐HIV clinics: A secondary analysis from a scoping review on HIV models of geriatric care

Kokorelias,

Grosse,

Zhabokritsky

et al. 2023

HIV Medicine

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ObjectivesThis review aimed to map the current state of knowledge regarding the implementation considerations of existing geriatric‐HIV models of care, to identify areas of further research and to inform the implementation of future geriatric‐HIV interventions that support older adults living with HIV.MethodsWe conducted a scoping review that was methodologically informed by the Arskey and O’Malley's 5 step framework and theoretically informed by the Consolidated Framework for Implementation Research (CFIR). A systematic search of six databases was conducted for peer‐reviewed literature. The grey literature was also searched. Article screening was performed in duplicate. Data was extracted for the purpose of this secondary analysis using a data extraction template informed by the CFIR. Data was inductively and deductively analyzed.ResultsIn total, 11 articles met the inclusion criteria. The models of care described varied in terms of their location and setting, the number and type of care providers involved, the mechanism of patient referral, the type of assessments and interventions performed and the methods of longitudinal patient follow‐up. Four key categories emerged to describe factors that influenced their implementation: care provider buy‐in, patient engagement, mechanisms of communication and collaboration, and available resources.ConclusionsThe findings from this scoping review provide an initial understanding of the key factors to consider when implementing geriatric‐HIV models of care. We recommend health system planners consider mechanisms of communication and collaboration, opportunities for care provider buy‐in, patient engagement and available resources. Future research should explore implementation in more diverse settings to understand the nuances that influence implementation and care delivery.

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Section: Resultsmentioning

confidence: 99%

Exploring implementation considerations for geriatric‐HIV clinics: A secondary analysis from a scoping review on HIV models of geriatric care

Kokorelias,

Grosse,

Zhabokritsky

et al. 2023

HIV Medicine

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“…The Covid pandemic and its disruption of healthcare services have served as an impetus for clinical programs in HIC to look to DSD as a means of delivering tailored care, as well. 114 A recent HIV Medicine White Paper also calls for innovative care models in the US based on DSD and “Street Medicine”. 131 Unsiloing of aging-related social services, HIV-related social services, and medical care.…”

Section: Discussion: Are We Doing Enough?mentioning

confidence: 99%

“…The COVID-19 pandemic has also necessitated creative responses to disruptions in care. 114 In response to these changing needs, a number of innovative clinical models attempting some level of care integration have been developed or proposed:…”

Section: Existing Care Models and Care Integrationmentioning

confidence: 99%

Treatment Regimens and Care Models for Older Patients Living with HIV: Are We Doing Enough?

Frey¹,

Johnston²,

Siegler³

2023

HIV

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With improved access to antiretroviral therapy throughout the world, people are aging with HIV, and a large portion of the global population of people with HIV (PWH) is now age 50 or older. Older PWH experience more comorbidities, aging-related syndromes, mental health challenges, and difficulties accessing fundamental needs than the population of older adults without HIV. As a result, ensuring that older PWH are receiving comprehensive healthcare can often be overwhelming for both PWH and the providers. Although there is a growing literature addressing the needs of this population, gaps remain in care delivery and research. In this paper, we suggest seven key components to any healthcare program designed to address the needs of older people with HIV: management of HIV, comorbidity screening and treatment, primary care coordination and planning, attention to aging related-syndromes, optimization of functional status, support of behavioral health, and improved access to basic needs and services. We review many of the difficulties and controversies related to the implementation of these components, which include the absence of screening guidelines for this population and the challenges of care integration, and we suggest key next steps.

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“…For instance, during the COVID-19 outbreak, the pandemic potentially threatens old PLWH disproportionately to the general population, both in mortality risk due to age and comorbidities, and in potential deleterious effects of policies that drastically limit in-person interaction and access to healthcare systems. 24 In addition, cognitive impairments and falls in older PLWH are common health concerns that can have severe consequences. There is a high prevalence of falls among PLWH who are of advanced age and also have mental health comorbidities, especially among patients who experience stigma and loneliness.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to chronic comorbidities, people aging with HIV face additional morbidities. For instance, during the COVID-19 outbreak, the pandemic potentially threatens old PLWH disproportionately to the general population, both in mortality risk due to age and comorbidities, and in potential deleterious effects of policies that drastically limit in-person interaction and access to healthcare systems 24 . In addition, cognitive impairments and falls in older PLWH are common health concerns that can have severe consequences.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Depression in Elderly People Living With HIV: A Systematic Review and Meta-analysis

Ahmed,

Saha,

Almusalami

et al. 2023

Infect Microb Dis

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We conducted a systematic review and meta-analysis to determine the prevalence of depression among elderly people living with HIV. We searched electronic databases and included 12 observational studies that reported on depression among people who were 50 years of age or older and had HIV. The studies were mostly hospital-based and from Western and African countries. They included a total of 5868 older people with HIV, of whom 1667 had depression. Pooled prevalence of depression was 28% with heterogeneity of 95.2%. Prevalence ranged from 14.5% in the Netherlands to 42.4% in South Africa. Although there was asymmetry in the funnel plot, the Egger’s test showed no significant publication bias. Our meta-analysis found a high burden of depression among older people with HIV. Comprehensive health services addressing psychosocial needs and interventions to prevent and treat depression are needed, especially in community settings. Healthcare providers and policymakers should address the prevalence of depression in such communities.

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People aging with HIV – protecting a population vulnerable to effects of COVID-19 and its control measures

Cited by 6 publications

References 32 publications

Exploring implementation considerations for geriatric‐HIV clinics: A secondary analysis from a scoping review on HIV models of geriatric care

Exploring implementation considerations for geriatric‐HIV clinics: A secondary analysis from a scoping review on HIV models of geriatric care

Treatment Regimens and Care Models for Older Patients Living with HIV: Are We Doing Enough?

Prevalence of Depression in Elderly People Living With HIV: A Systematic Review and Meta-analysis

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