Older people with HIV are an essential part of the continuum of HIV care

Sexual minority individuals experience barriers to receiving equitable health care. Research also indicates that young men who have sex with men (YMSM), particularly young men of color, have limited engagement in the HIV care continuum and there are significant disparities across the continuum. This study aims to uncover how providers can engage YMSM of color in all forms of care, including primary care and HIV prevention through an HIV prevention continuum. This qualitative study reports data from the Healthy Young Men's Cohort Study; a total of 49 YMSM participated in the eight focus groups. This study provides a description of YMSM's overall health concerns, experiences with health care, and under what circumstances YMSM seek care. We then present a model describing the salient characteristics of a HIV prevention continuum for YMSM of color and provide clear areas for education, intervention, and policy change to support better overall health for YMSM of color.

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The continuum of HIV care in South Africa

AIDS ◽

10.1097/qad.0000000000001340 ◽

2017 ◽

Vol 31 (4) ◽

pp. 545-552 ◽

Cited By ~ 24

Author(s):

Simbarashe Takuva ◽

Alison E. Brown ◽

Yogan Pillay ◽

Valerie Delpech ◽

Adrian J. Puren

Keyword(s):

South Africa ◽

Hiv Care ◽

The Continuum

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Sexually transmissible infections in aging HIV populations

Sexual Health ◽

10.1071/sh11027 ◽

2011 ◽

Vol 8 (4) ◽

pp. 508 ◽

Cited By ~ 11

Author(s):

I. Mary Poynten ◽

David J. Templeton ◽

Andrew E. Grulich

Keyword(s):

High Risk ◽

Older People ◽

Gay Men ◽

Sexual Behaviour ◽

Hiv Care ◽

People Living With Hiv ◽

Older Individuals ◽

Sexually Transmissible Infections ◽

Younger Men ◽

Risk Sexual Behaviour

There is limited published research on sexually transmissible infections (STI) among aging HIV populations. The available literature on sexual behaviour and STI among older people with HIV is reviewed here and contrasted with data from older individuals in the general population and from older populations at high risk of HIV. A sizeable minority of older people with HIV continue to engage in higher risk sexual behaviour and thus remain at high risk of STI. There is no clear evidence of a consistent effect of older age on STI rates, clinical presentation or clinical course among HIV-infected populations, although gay men with HIV aged in their 40s or older seem to be at higher risk than younger men of acquiring several STI, including syphilis and lymphogranuloma venereum. STI risks in older people living with HIV need to be regularly assessed. Higher risk sexual behaviour and disproportionately higher rates of STI indicate that regardless of age, a thorough STI assessment should be regularly undertaken for all HIV-positive gay men as part of their routine HIV care.

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A Role for Health Communication in the Continuum of HIV Care, Treatment, and Prevention

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000000239 ◽

2014 ◽

Vol 66 ◽

pp. S306-S310 ◽

Cited By ~ 21

Author(s):

Cecilia Tomori ◽

Kathryn Risher ◽

Rupali J. Limaye ◽

Lynn M. Van Lith ◽

Susannah Gibbs ◽

...

Keyword(s):

Health Communication ◽

Hiv Care ◽

Treatment And Prevention ◽

Care Treatment ◽

The Continuum

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Examining the Impact of the Golden Compass Clinical Care Program for Older People with HIV: A Qualitative Study

AIDS and Behavior ◽

10.1007/s10461-021-03509-0 ◽

2021 ◽

Author(s):

Judy Y. Tan ◽

Meredith Greene ◽

Cinthia Blat ◽

Autumn Albers ◽

Janet Grochowski ◽

...

Keyword(s):

Quality Of Life ◽

Older People ◽

Functional Ability ◽

Primary Care Providers ◽

Functional Health ◽

Hiv Care ◽

Clinical Approach ◽

Care Providers ◽

The Impact

AbstractThe combined burden of geriatric conditions, comorbidities, and HIV requires a model of HIV care that offers a comprehensive clinical approach with people 50 years or older with HIV. Golden Compass is an outpatient, multidisciplinary HIV-geriatrics program with an onsite HIV geriatrician, cardiologist, pharmacist, and social worker, offering specialist referrals, care navigation, and classes on improving functional status and cognition. Participants (13 patients and 11 primary care providers) were recruited using a non-probability sampling method to participate in semi-structured interviews on the perceived impact of Golden Compass on care delivered to older people with HIV. Interviews were transcribed verbatim and framework analysis used to analyze the transcripts. The perceived impacts of Golden Compass by patients and providers were organized by the Compass points (Northern: Heart and Mind, Eastern: Bones and Strength, Southern: Navigation and Network, Western: Dental, Hearing, and Vision). Overall, patients valued the focus on functional health and whole-person care, leading to greater trust in the ability of providers. Providers gained new skills through the geriatrics, cardiology and/or pharmacist consultations. The HIV-geriatrics specialty approach of Golden Compass improved functional ability and quality of life for older adults with HIV. Few integrated care programs for older people with HIV have been evaluated. This study adds to the limited literature demonstrating high patient and provider satisfaction with a HIV-care model that incorporated principles of geriatric medicine emphasizing a comprehensive approach to sustaining functional ability and improving quality of life.

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Consequences of the COVID-19 pandemic on the continuum of the care in a cohort of people living with HIV followed in a single center of Northern Italy

10.21203/rs.3.rs-38253/v2 ◽

2020 ◽

Author(s):

Eugenia Quiros-Roldan ◽

Paola Magro ◽

Canio Carriero ◽

Annacarla Chiesa ◽

Issa El Hamad ◽

...

Keyword(s):

Antiretroviral Drugs ◽

Hiv Care ◽

Categorical Variables ◽

People Living With Hiv ◽

Continuous Variables ◽

Hiv Diagnosis ◽

Missed Visits ◽

Hiv Continuum Of Care ◽

Living With Hiv ◽

The Continuum

Abstract Introduction: During the COVID-19 pandemic, hospitals faced increasing pressure, where people living with HIV risked to either acquire SARS-CoV-2 and to interrupt the HIV continuum of care.Methods: this is a retrospective, observational study. We compared the numbers of medical visits performed, antiretroviral drugs dispensed and the number of new HIV diagnosis and of hospitalizations in a cohort of people living with HIV (PLWH) followed by the Spedali Civili of Brescia between the bimester of the COVID-19 pandemic peak and the bimester of October-November 2019. Data were retrieved from administrative files and from paper and electronic clinical charts. Categorical variables were described using frequencies and percentages, while continuous variables were described using mean, median, and interquartile range (IQR) values. Means for continuous variables were compared using Student’s t-tests and the Mann-Whitney test. Proportions for categorical variables were compared using the χ2 test.Results: As of December 31st, 2019, a total of 3875 PLWH were followed in our clinic. Mean age was 51,4 ±13 years old, where 28% were females and 18.8% non-Italian. Overall, 98.9% were on ART (n=3834), 93% were viro-suppressed. A total of 1217 and 1162 patients had their visit scheduled at our out-patient HIV clinic during the two bimesters of 2019 and 2020, respectively. Comparing the two periods, we observed a raise of missed visits from 5% to 8% (p<0.01), a reduction in the number of new HIV diagnosis from 6.4 in 2019 to 2.5 per month in 2020 (p=0.01), a drop in ART dispensation and an increase of hospitalized HIV patients due to COVID-19. ART regimens including protease inhibitors (PIs) had a smaller average drop than ART not including PIs (16,6% vs 21,6%, p<0.05). Whether this may be due to the perception of a possible efficacy of PIs on COVID19 is not known. Conclusions: Our experience highlights the importance of a resilient healthcare system and the need to implement new strategies in order to guarantee the continuum of HIV care even in the context of emergency.

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