Abstract
With the advent of highly active antiretroviral therapy (HAART), HIV has become a manageable chronic infection and individuals with it are living longer. Older individuals with HIV will begin to seek services across the continuum of health care. Whether their care needs differ from those who are HIV negative has not been well-characterized. To compare the demographic characteristics, chronic conditions, presence of infections, and mental health issues among HIV-positive versus HIV-negative individuals in home care, long-term care and complex continuing care settings across Canada. This cross-sectional study used interRAI data to compare characteristics of HIV-positive and HIV-negative individuals in long-term care, complex continuing care and home care settings. Chi-square analyses explored differences between groups on co-infections, chronic disease and mental health issues. Data from 1,200,073 people were analyzed of whom 1,608 (0.13%) had HIV. Overall, HIV-positive individuals had more co-infections but fewer chronic diseases than their HIV-negative counterparts. Depression, social isolation and the use of psychotropic medications were generally more prevalent in the HIV-positive cohort. People living with HIV make up a small cohort of people with complex needs in home care and institutional settings and their care needs differ from those who are HIV negative. As HIV-positive people age, a better understanding of the context in which these issues are experienced will support appropriate interventions.
Highlights
In many developed countries, advances in human immunodeficiency virus (HIV) management, namely highly active antiretroviral therapy (HAART), mean that HIV infection has become a chronic disease
For persons living with HIV-acquired immunodeficiency syndrome (AIDS) (PHAs), comorbidity profiles are shifting away from AIDS-defining illnesses toward HIV-associated non-AIDS illnesses such as cardiovascular and kidney diseases [1,2]
This study included data from Canadian home care (HC), long-term care (LTC) and complex continuing care (CCC) settings, which are defined in the following text box
Summary
Advances in HIV management, namely highly active antiretroviral therapy (HAART), mean that HIV infection has become a chronic disease. Approximately two-thirds of older PHAs live with other chronic conditions [3,4,5,6,7,8,9,10,11] The onset of these chronic conditions occurs earlier than in HIV-negative individuals [1,5,11] and comorbidity includes more infections due to immune suppression and HAART [1,2,12]. Despite advances in HAART, HIV-associated neurocognitive disorders are well-described long-term outcomes of HIV infection [13]. This population likely differs greatly from younger PHAs and older adults without HIV, making the particular care needs of older PHAs unique. Whether their care needs differ from those who are HIV negative has not been well-characterized
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