Join Us, All are Welcome, We want to hear from you!
The purpose of a town hall is to create a safe space for community to share what they know with neighbors. Those of us STRIVING with HIV and over 50 years of age are concerned we are the first generation of people aging with HIV ever seen by doctors and health officials.
LKAPS.org supports education and advocacy to raise awareness of long-term survivors' challenges, and treatment and support needs.
Topics for Discussion:
What are Standards of Care and what should I expect from healthcare?
Has my HIV care changed now that I am over 50 years old?
My doctor is about to retire. What are my options?
and much more!
The purpose of this memo is to prepare community for the discussion by defining Standards of Care and why they are important.
We hope to see all stakeholders the morning of Sat. March 21!
Standards of Care - Definition
Standard of Care: 1. A diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance. Adjuvant chemotherapy for lung cancer is "a new standard of care, but not necessarily the only standard of care." (New England Journal of Medicine, 2004)
2. In legal terms, the level at which the average, prudent provider in a given community would practice. It is how similarly qualified practitioners would have managed the patient's care under the same or similar circumstances. The medical malpractice plaintiff must establish the appropriate standard of care and demonstrate that the standard of care has been breached.
(Medical Author: William C. Shiel Jr., MD, FACP, FACR)
Standards of Care - Ryan White
Los Angeles County Standards of Care (http://hiv.lacounty.gov/Standard-Of-Care).
Review of Universal Standards of Care - Ryan White Program (L.A. County) (http://hiv.lacounty.gov/LinkClick.aspx?fileticket=K7W StThpUA%3d&portalid=22)
New York State: This reference guide for care of older adults with HIV supplements, but does not replace, standard guidelines for all adults with HIV found on this website. (https://www.hivguidelines.org/hiv-care/selected-resources/quick-reference-guides/hiv-in-olderadults)
As this field of research evolves, many research gaps need to be addressed, including a better conceptualization and measurement of successful aging and the development of high-quality integrated care, programs, and services tailored to the needs of older people with HIV. A more integrated policy response is needed to improve the psychosocial and economic well-being of older people with HIV. (Psychosocial, Mental Health, and Behavioral Issues of Aging with HIV, by Sergio Rueda, Stephanie Lawd, and Sean B. Rourkea, 2014 [Lippincott Williams & Wilkins).
Older patients (>50 years of age) should be initiated on treatment as soon as possible after diagnosis because this population:
Experiences accelerated CD4 loss
Has decreased immune recovery
Is at increased risk of serious non-AIDS illnesses
As people age, they typically have more comorbidities, take more medications, and are more vulnerable to side effects-complicating management of their disease.
Age-associated noncommunicable comorbidities (including hypertension, myocardial infarction, and peripheral artery disease) were numerically more prevalent among people living with HIV than HIV-uninfected controls
Aging people with HIV often develop inflammation and cardiovascular, kidney, liver, bone, and neurologic disease 6-8
Potential side effects and drug-drug interactions for aging-associated comorbidities can further complicate ART management
People who acquire resistance to one or more antiretroviral (ARV) drugs as they age limit their available treatment options if they develop virologic failure in the future. Choosing a regimen with simple administration may help people remain adherent, reducing their chance of developing resistance in the presence of suboptimal drug levels. (From HelpStoptheViruspro.com)