A systematic review of engagement in care and health care utilization among older adults living with HIV and non-communicable diseases

ABSTRACT

It is critical to understand health care engagement and utilization among older persons living with HIV (OPWH) who may have greater burden for non-communicable diseases. Following the PRISMA guidelines, a systematic review using 5 electronic databases was conducted to appraise and synthesize the current literature on the relationship of non-communicable diseases on engagement in care and health care utilization among OPWH. Original studies published in English between 2009 and 2019 were included, yielding 16 relevant articles. Overall, having co-morbid non-communicable diseases was associated with a decreased likelihood of initiating and adhering to ART. Being on ART and viral suppression were associated with better engagement in non-communicable disease care. Findings also suggest that an increasing number of co-morbidities is associated with higher health care utilization and financial burden. This review underscores the need for preventing and managing co-morbidities to enhance engagement in HIV care and that health care practitioners need to ensure that OPWH are engaged in care for both HIV and their co-morbid conditions by providing coordinated and integrated care.

KEYWORDS:

• Engagement in care
• health care utilization
• non-communicable diseases
• chronic conditions
• systematic review

Acknowledgements

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to thank John Uselligo, Health Informationist at Columbia University, for his input on the search strategy and review of this systematic review’s methodology. MYJ conceptualized the study, developed and performed search protocol, extracted data, and drafted the manuscript, including the figure and tables. AA provided feedback and revisions on the initial versions of the manuscript and tables. AA and RBG reviewed search results, appraised the quality of included studies, and provided feedback on the manuscript. RS contributed to the writing and provided constructive feedback. All authors read, reviewed, and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the National Institute of Nursing Research of the National Institutes of Health under the following award numbers: T32NR014205, T32NR007969, and K24NR018621.