Alison A Moore ,Charles B Hicks ,Constance A Benson ,David J Moore ,James R Templeman ,Maile Young Karris,Philip M Polgreen ,Susan E Beekmann ,
“Undetectable, Now What?” HIV Provider Opinions on Barriers to Healthy Aging for Older People Living with HIV in North America
Gerontology and Geriatric Research
2020
2733-2292
http://dx.doi.org/10.31487/j.GGR.2020.01.01
https://www.sciencerepository.org/undetectable-now-what-hiv-provider_GGR-2020-1-101 
Abstract: Background: People living with HIV (PLWH) experience age-associated health conditions earlier than
their HIV-uninfected peers and have higher rates of co-occurring conditions that impact aging. Thus, HIV
providers frequently confront issues related to HIV and aging.
Objective: The objective of this project was to understand provider opinions about the care of older PLWH
better.
Design: This was accomplished using a quantitative survey.
Participants: This study involved 681 physicians treating PLWH in North America.
MAIN MEASURES: We collaborated with the Emerging Infections Network (EIN) to administer a ninequestion survey covering practice characteristics, attitudes, and perceived barriers in caring for older PLWH.
Key Results: Two hundred and ninety-four (43.2%) responses were collected. Providers estimate that 35%
(IQR: 25-50) of their HIV-infected patients were >50 years. The majority (72%) agreed it is difficult to care
for older PLWH but had confidence in their ability to do so (85%). Most list a lack of time (55.4%) and
insufficient multidisciplinary support (58.5%) as limitations to the effective management of older PLWH.
Multi-morbidity was overwhelmingly perceived as the most important barrier to healthy aging (62.2%)
followed by tobacco/alcohol use (10%), low income/savings (8.2%), polypharmacy (4.8%) and mental
illness (4.4%). Loneliness, frailty, and cognitive difficulties were judged to be less important. In conclusion,
HIV providers recognized the complexity of caring for older PLWH, and yet were confident they could care
for this population.
Conclusion: Multi-morbidity was identified as a major barrier to healthy aging, while syndromes such as
frailty and cognitive difficulties were deemed less important despite a growing body of evidence that these
geriatric syndromes are common in older PLWH.Keywords: Clinical Care, Geriatrics, HIV, Aging, HIV specialist