Why we need to re‐define long‐term success for people living with <scp>HIV</scp>

Fuster‐RuizdeApodaca, María José; Wohl, David A.; Cascio, Mario; Guaraldi, Giovanni; Rockstroh, Jürgen K.; Hodson, Matthew; Richman, Bruce W.; Brown, Gina; Anderson, Jane; Lazarus, Jeffrey V.

doi:10.1111/hiv.13461

Cited by 5 publications

(5 citation statements)

References 40 publications

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“…As a result of advances in HIV diagnosis, linkage to care, and treatment, the life expectancy of PLWH has improved significantly in recent decades. However, these advances have created a new set of challenges that must be addressed to ensure the long-term success (LTS) of PLWH [ 10 ]. Consequently, an LTS framework which offers a comprehensive and person-centric approach has been developed that includes five outcome pillars: sustained undetectable viral load, minimal impact of treatment and clinical monitoring, optimized health-related QoL, lifelong integration of healthcare, and freedom from stigma and discrimination [ 11 ].…”

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confidence: 99%

Identifying the Unmet Medical Needs of HIV-Positive Subjects in Korea: Results of a Nationwide Online Survey

Lee,

Kim,

Lee

et al. 2023

Infect Chemother

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An online survey was conducted in Korea to identify the unmet medical needs of people living with human immunodeficiency virus (HIV) (PLWH). Participants (n = 105) were mostly male (93.3%), aged >40 years (75.2%), and treated for ≥6 years post-diagnosis (61.9%). Most PLWH (71.4%) were very satisfied/satisfied with their HIV management. Areas of concern were quality of life (QoL) and mental health. Characteristics of a long-term therapeutic agent were ‘low risk of resistance’, ‘high long-term viral suppression efficacy’, and ‘high degree of safety’. Pre-consultation QoL and mental health screening would be beneficial for the long-term success of HIV management.

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confidence: 99%

Identifying the Unmet Medical Needs of HIV-Positive Subjects in Korea: Results of a Nationwide Online Survey

Lee,

Kim,

Lee

et al. 2023

Infect Chemother

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“…Taking care of NCDs is paramount to achieving a healthy, long life with high quality of life for people with HIV. While there is consensus that long‐term success in treatment can only be achieved by employing a multidisciplinary, integrated, person‐centred approach in healthcare delivery, little is known about the degree of healthcare integration and delivery for NCDs among people with HIV in the WHO European Region [18]. This study is the first to provide data from HIV clinics in 31 countries of the WHO European Region on approaches to integrated diagnosis and management of NCDs among this population.…”

Section: Discussionmentioning

confidence: 99%

“…The groups most prioritized for NCD screening and management were those aged ≥50 years and those with chronic hepatitis B and C coinfections. The focus of many clinics, the ageing population, seems well justified as they do bear the major burden of NCDs [18].…”

Section: Discussionmentioning

confidence: 99%

Differences in integrated assessment and management of non‐communicable diseases (NCDs) for people with HIV across the WHO European region

Kraef,

Singh,

Fursa

et al. 2024

HIV Medicine

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ObjectivesWe aimed to assess the extent of integration of non‐communicable disease (NCD) assessment and management in HIV clinics across Europe.MethodsA structured electronic questionnaire with 41 multiple‐choice and rating‐scale questions assessing NCD assessment and management was sent to 88 HIV clinics across the WHO European Region during March–May 2023. One response per clinic was collected.ResultsIn all, 51 clinics from 34 countries with >100 000 people with HIV under regular follow‐up responded. Thirty‐seven clinics (72.6%) reported shared NCD care responsibility with the general practitioner. Systematic assessment for NCDs and integration of NCD management were common overall [median agreement 80%, interquartile range (IQR): 55–95%; and 70%, IQR: 50–88%, respectively] but were lowest in central eastern and eastern Europe. Chronic kidney disease (median agreement 96%, IQR: 85–100%) and metabolic disorders (90%, IQR: 75–100%) were regularly assessed, while mental health (72%, IQR: 63–85%) and pulmonary diseases (52%, IQR: 40–75%) were less systematically assessed. Some essential diagnostic tests such as glycated haemoglobin (HbA1c) for diabetes (n = 38/51, 74.5%), proteinuria for kidney disease (n = 30/51, 58.8%) and spirometry for lung disease (n = 11/51, 21.6%) were only employed by a proportion of clinics. The most frequent barriers for integrating NCD care were the lack of healthcare workers (n = 17/51, 33.3%) and lack of time during outpatient visits (n = 12/51, 23.5%).ConclusionMost HIV clinics in Europe systematically assess and manage NCDs. People with HIV appear to be screened more frequently than the general population at the same age. There are, however, larger gaps among eastern European clinics in general and for clinics in all regions related to mental health, pulmonary diseases and the employment of some essential diagnostic tests.

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“…Lazarus et al (2023) went on to establish a Long Term Success Framework living with HIV, that highlighted optimizing health related quality of life as a key goal for persons living with HIV [ 11 ]. Achieving this success would require an integrated person-centered approach to care that goes beyond viral suppression to consider multimorbidity, and include comprehensive person-centred approaches to care that optimize self-perceived quality of life for persons living with HIV [ 9 , 11 – 14 ]. Rehabilitation is well positioned to achieve long term success aging with HIV as it involves the dynamic process of prevention or treatment activities and services that address symptoms, functional limitations and social participation restrictions.…”

Section: Introductionmentioning

confidence: 99%

Research priorities in HIV, aging and rehabilitation: building on a framework with the Canada-International HIV and Rehabilitation Research Collaborative

O’Brien,

Ibáñez-Carrasco,

Birtwell

et al. 2023

AIDS Res Ther

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Background In 2016, the Canada-International HIV and Rehabilitation Research Collaborative established a framework of research priorities in HIV, aging and rehabilitation. Our aim was to review and identify any new emerging priorities from the perspectives of people living with HIV, clinicians, researchers, and representatives from community organizations. Methods We conducted a multi-stakeholder international consultation with people living with HIV, researchers, clinicians and representatives of community-based organizations. Stakeholders convened for a one-day Forum in Manchester, United Kingdom (UK) to discuss research priorities via a web-based questionnaire and facilitated discussions. We analyzed data using conventional content analytical techniques and mapped emerging priorities onto the foundational framework. Results Thirty-five stakeholders from the UK(n = 29), Canada(n = 5) and Ireland(n = 1) attended the Forum, representing persons living with HIV or representatives from community-based organizations(n = 12;34%), researchers or academics(n = 10;28%), service providers(n = 6;17%), clinicians(n = 4;11%); and trainees(n = 4;11%). Five priorities mapped onto the Framework of Research Priorities across three content areas: A–Episodic Health and Disability Aging with HIV (disability, frailty, social participation), B-Rehabilitation Interventions for Healthy Aging across the Lifespan (role, implementation and impact of digital and web-based rehabilitation interventions) and C–Outcome Measurement in HIV and Aging (digital and web-based rehabilitation health technology to measure physical activity). Stakeholders indicated methodological considerations for implementing digital and web-based rehabilitation interventions into research and practice and the importance of knowledge transfer and exchange among the broader community. Conclusion Results highlight the sustained importance of the Framework of Research Priorities and provide further depth and areas of inquiry related to digital and web-based rehabilitation interventions and technology aging with HIV.

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Why we need to re‐define long‐term success for people living with HIV

Cited by 5 publications

References 40 publications

Identifying the Unmet Medical Needs of HIV-Positive Subjects in Korea: Results of a Nationwide Online Survey

Identifying the Unmet Medical Needs of HIV-Positive Subjects in Korea: Results of a Nationwide Online Survey

Differences in integrated assessment and management of non‐communicable diseases (NCDs) for people with HIV across the WHO European region

Research priorities in HIV, aging and rehabilitation: building on a framework with the Canada-International HIV and Rehabilitation Research Collaborative

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