Perspectives on Continuing Care, From Home Care to Long-Term Care, for Older People Living With HIV: A Cross-Sectional Study

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL
Jacqueline M. McMillan, Jessica Dalere, Farwa Naqvi, Vivian Ewa, Raynell Lang, Raman Brar, Katrina Milaney, Jeffrey A. Bakal, Hartmut B. Krentz, Patrick B. Quail, Caley B. Shukalek, Jenine Leal, Nolan E. Hill, Mark Randall, M. John Gill
{"title":"Perspectives on Continuing Care, From Home Care to Long-Term Care, for Older People Living With HIV: A Cross-Sectional Study","authors":"Jacqueline M. McMillan,&nbsp;Jessica Dalere,&nbsp;Farwa Naqvi,&nbsp;Vivian Ewa,&nbsp;Raynell Lang,&nbsp;Raman Brar,&nbsp;Katrina Milaney,&nbsp;Jeffrey A. Bakal,&nbsp;Hartmut B. Krentz,&nbsp;Patrick B. Quail,&nbsp;Caley B. Shukalek,&nbsp;Jenine Leal,&nbsp;Nolan E. Hill,&nbsp;Mark Randall,&nbsp;M. John Gill","doi":"10.1002/hsr2.70578","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Aims</h3>\n \n <p>Older (≥ 50 years) persons living with human immunodeficiency virus (PLWH) comprise the majority of individuals receiving HIV care in high-income countries. PLWH experience the challenges of aging at earlier ages and accelerated rates, compared to people without HIV. Older PLWH who may benefit from more support may hesitate due to fear of stigma, discrimination, or past experiences.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We assessed the views of older PLWH through an online survey. We sought participants' views, experiences, knowledge and preferences for delivery of continuing care support in Alberta, Canada. Participants were invited during clinic visits at the Southern Alberta Clinic in Calgary, Canada.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 316 participants completed the survey. The mean age was 61 years (standard deviation ± 8) and 83.5% (<i>n</i> = 264) were men. Ten percent of participants (<i>n</i> = 32) currently receive help with activities of daily living, 70% of which was provided by family/friends. Nine percent expressed concern with receiving help, including financial (54%), loss of independence (31%), and privacy concerns (31%). Nearly 47% expressed concern about healthcare providers' knowledge of HIV, 63% expressed concern about their medical information being kept confidential, and 64% expressed concern about other residents learning of their HIV diagnosis.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Despite a need, many older PLWH are hesitant to accept home care or move into supportive, facility-based living. This leaves a potential void in the necessary provision of care. This must be addressed to ensure equity, diversity, and inclusion, and to remove barriers in accessing health and social supports. The solutions to this urgent need lie with those with lived experience who can inform healthcare providers and policy-makers. To start, healthcare providers and policymakers must educate staff about the ongoing stigma and discrimination experienced by older PLWH and demonstrate to patients the value placed on patient privacy and confidentiality.</p>\n </section>\n \n <section>\n \n <h3> Impact Statement</h3>\n \n <p>We certify that this work is novel clinical research that provides insight into the values and preferences of older people living with HIV regarding continuing care (from home care to supportive living and long-term care). This work is the foundation for creating meaningful, structural changes to how continuing care is provided to older people living with HIV, an underrepresented and equity-deserving group. Despite a need, many older PLWH are hesitant to accept home care or move into supportive, facility-based living. This leaves a potential void in the necessary provision of care. This must be addressed to ensure equity, diversity, and inclusion, and to remove barriers in accessing health and social supports. To start, healthcare providers and policymakers must educate staff about the ongoing stigma and discrimination experienced by older PLWH and demonstrate to patients the value placed on patient privacy and confidentiality.</p>\n </section>\n </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 3","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922802/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Science Reports","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hsr2.70578","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background and Aims

Older (≥ 50 years) persons living with human immunodeficiency virus (PLWH) comprise the majority of individuals receiving HIV care in high-income countries. PLWH experience the challenges of aging at earlier ages and accelerated rates, compared to people without HIV. Older PLWH who may benefit from more support may hesitate due to fear of stigma, discrimination, or past experiences.

Methods

We assessed the views of older PLWH through an online survey. We sought participants' views, experiences, knowledge and preferences for delivery of continuing care support in Alberta, Canada. Participants were invited during clinic visits at the Southern Alberta Clinic in Calgary, Canada.

Results

A total of 316 participants completed the survey. The mean age was 61 years (standard deviation ± 8) and 83.5% (n = 264) were men. Ten percent of participants (n = 32) currently receive help with activities of daily living, 70% of which was provided by family/friends. Nine percent expressed concern with receiving help, including financial (54%), loss of independence (31%), and privacy concerns (31%). Nearly 47% expressed concern about healthcare providers' knowledge of HIV, 63% expressed concern about their medical information being kept confidential, and 64% expressed concern about other residents learning of their HIV diagnosis.

Conclusions

Despite a need, many older PLWH are hesitant to accept home care or move into supportive, facility-based living. This leaves a potential void in the necessary provision of care. This must be addressed to ensure equity, diversity, and inclusion, and to remove barriers in accessing health and social supports. The solutions to this urgent need lie with those with lived experience who can inform healthcare providers and policy-makers. To start, healthcare providers and policymakers must educate staff about the ongoing stigma and discrimination experienced by older PLWH and demonstrate to patients the value placed on patient privacy and confidentiality.

Impact Statement

We certify that this work is novel clinical research that provides insight into the values and preferences of older people living with HIV regarding continuing care (from home care to supportive living and long-term care). This work is the foundation for creating meaningful, structural changes to how continuing care is provided to older people living with HIV, an underrepresented and equity-deserving group. Despite a need, many older PLWH are hesitant to accept home care or move into supportive, facility-based living. This leaves a potential void in the necessary provision of care. This must be addressed to ensure equity, diversity, and inclusion, and to remove barriers in accessing health and social supports. To start, healthcare providers and policymakers must educate staff about the ongoing stigma and discrimination experienced by older PLWH and demonstrate to patients the value placed on patient privacy and confidentiality.

Abstract Image

从家庭护理到长期护理,感染艾滋病毒的老年人对持续护理的看法:一项横断面研究。
背景和目的:在高收入国家,老年人(≥50岁)感染人类免疫缺陷病毒(PLWH)的人占接受艾滋病毒治疗的大多数。与未感染艾滋病毒的人相比,艾滋病病毒感染者面临着年龄更早、速度更快的衰老挑战。年长的PLWH可能会受益于更多的支持,但由于害怕耻辱、歧视或过去的经历,他们可能会犹豫不决。方法:我们通过在线调查评估老年PLWH的观点。我们寻求参与者对加拿大阿尔伯塔省提供持续护理支持的观点、经验、知识和偏好。参加者是在加拿大卡尔加里的南阿尔伯塔诊所就诊期间被邀请的。结果:共有316名参与者完成了调查。平均年龄61岁(标准差±8),男性占83.5% (n = 264)。10%的参与者(n = 32)目前接受日常生活活动的帮助,其中70%是由家人/朋友提供的。9%的人表示担心接受帮助,包括财务(54%)、失去独立性(31%)和隐私问题(31%)。近47%的人表示担心医护人员对艾滋病毒的了解,63%的人表示担心他们的医疗信息被保密,64%的人表示担心其他居民了解他们的艾滋病毒诊断。结论:尽管有需求,许多老年PLWH仍不愿接受家庭护理或搬进支持性的、以设施为基础的生活。这在提供必要的护理方面留下了潜在的空白。必须解决这一问题,以确保公平、多样性和包容性,并消除获得保健和社会支持方面的障碍。解决这一迫切需求的办法在于那些有生活经验的人,他们可以告知医疗保健提供者和决策者。首先,医疗保健提供者和政策制定者必须教育员工,让他们了解老年PLWH所经历的持续耻辱和歧视,并向患者展示对患者隐私和保密的重视。影响声明:我们证明这项工作是一项新颖的临床研究,它提供了对老年艾滋病毒感染者关于持续护理(从家庭护理到支持性生活和长期护理)的价值观和偏好的见解。这项工作是为如何向感染艾滋病毒的老年人提供持续护理进行有意义的结构性变革的基础,这是一个代表性不足且应该得到平等对待的群体。尽管有这样的需求,但许多老年PLWH仍不愿接受家庭护理或搬进支持性的、以设施为基础的生活。这在提供必要的护理方面留下了潜在的空白。必须解决这一问题,以确保公平、多样性和包容性,并消除获得保健和社会支持方面的障碍。首先,医疗保健提供者和政策制定者必须教育员工,让他们了解老年PLWH所经历的持续耻辱和歧视,并向患者展示对患者隐私和保密的重视。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Health Science Reports
Health Science Reports Medicine-Medicine (all)
CiteScore
1.80
自引率
0.00%
发文量
458
审稿时长
20 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信