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Aging- HIV Clinic/NYC - "We are Unprepared to Care for Aging"
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Download the PDF her
http://www.aahivm.org/HIV_Specialist/upload/FINAL MARCH 2016.pdf
"In light of near-normal lifespans for PLHA, a recent Dutch study projected that by 2030, 73% of those infected with HIV will be at least 50 years of age and 39% will be 60 years or older.2
Those who are over 50 years of age must contend with HIV infection and aging simultaneously, and the current workforce is unprepared to care for this aging population"
MORE THAN 40% OF PEOPLE LIVING WITH HIV OR AIDS
(PLHA) in the United States in 2012 were at least 50 years of age,1 and approximately 18% of new HIV infections occurred in this same age group.1 But that is just the beginning. In light of near-normal lifespans for PLHA, a recent Dutch study projected that by 2030, 73% of those infected with HIV will be at least 50 years of age and 39% will be 60 years or older.2
Those who are over 50 years of age must contend with HIV infection and aging simultaneously, and the current workforce is unprepared to care for this aging population. It is also unlikely that a sizeable cohort of physicians or advanced practice nurses currently in training will graduate with expertise in both aging and HIV care.
So, how can we expand the capabilities of HIV practices to meet the needs of an aging population?
Establishing a Clinical Program
for People Aging with HIV
At the Center for Special Studies (CSS), the adult HIV practice at Weill Cornell Medicine/New York Presbyterian Hospital, we are attempting to meet our aging patients’ needs by establishing an Aging with HIV program.
At CSS, 61% of patients are 50 years or older; more than one third of them, nearly 500 patients, are at least 60 years old. CSS provides interdisciplinary care, with social workers, psychiatrists, gynecologists, and nutritionists on site. At the end of the workday, each patient is discussed in group rounds, attended by all staff.
We first explored the idea of a program to help older patients by talking with HIV physicians and making geriatric consultation available to HIV
providers on an ad-hoc basis at the outpatient CSS practice. We also visited community agencies that specialized in supportive HIV and/or aging care. We then crafted a proposal and obtained funding from the Fan Fox and Leslie R. Samuels Foundation to implement an HIV
aging program that started in July 2015. The program has several components:
⋅ Embedding a geriatrician in the HIV practice.
The geriatrician consults one afternoon a week on site, documents in the shared electronic medical record, and joins afternoon rounds.
⋅ Performing a needs assessment.
We interviewed representatives of CSS staff and met with each discipline individually to determine what they felt they needed and how they wanted to participate in the program. We are conducting patient focus groups in both English and Spanish among MSM, women, and heterosexual men.
⋅ Educating staff.
⋅ Working with community agencies. We are collaborating with SAGE (Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders, http://www.sageusa.org/nyc/), to create joint educational programs for people aging with HIV infection.
We are also creating research partnerships, exploring funding opportunities with other foundations, and considering relationships with insurers and providers of long-term care.
The workforce challenges and how we approached them remain relevant to any practice interested in expanding its offerings to meet the needs of elderly. Irrespective of practice size or location, caring for the aging HIV-infected adult will necessitate reaching out to those who have aging expertise, with whom HIV experts can collaborate and from whom they can learn.
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