HIV/AIDS: Research and Palliative Care (Apr 2023)
Treatment Regimens and Care Models for Older Patients Living with HIV: Are We Doing Enough?
Abstract
Emily Frey,1 Carrie D Johnston,2 Eugenia L Siegler3 1Department of Medicine, Weill Cornell/New York Presbyterian Hospital, New York, NY, USA; 2Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, USA; 3Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, NY, USACorrespondence: Emily Frey, Department of Medicine, Weill Cornell Medicine, 505 East 70th Street, New York, NY, 10021, USA, Tel +1 212 746 4749, Fax +1 212 746 4609, Email [email protected]: 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.Keywords: older people with HIV, care integration, antiretroviral therapy, multimorbidity, aging-related syndromes
