Practical management of complexity in older people with HIV: approaching an international consensus

ABSTRACT

Globally the community of people with HIV is ageing, and some of these have increasingly complex care needs, with a known excess of non-HIV related comorbidities and related issues including consequent polypharmacy. At the 2022 International AIDS Conference in Montréal, Canada, the “Silver Zone” was created in the Global Village as a safe space for older people with HIV. As part of the Silver Zone activities, a session discussing global models of care for in this group was held. HIV treatment providers and advocates from diverse resource settings and with a diversity of expertise were invited to share their experience, reflections, and ideas, and this consensus statement was formed based on these discussions. Different approaches to care emerged, based on local needs and resources, and it became clear that issues of complexity and frailty need not be age limited. Despite clear regional differences, some common themes became apparent, and a consensus was established on basic principles that may be considered in diverse settings. These are discussed here, with agreement on necessary proximal steps to develop bespoke person-centred care models.

KEYWORDS:

• HIV
• ageing
• complexity
• frailty
• comorbidities
• geriatric
• person-centred

Acknowledgements

We thank the International AIDS Society, the organisers of the 2022 International AIDS Conference, and the convenors of the Silver Zone in the Global Village. We also thank all participants in the session who raised questions and contributed to the discussion leading to this consensus statement, particularly those living with HIV personally and whose lived testimony is so valuable.

Disclosure statement

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

Author contributions

TJB and JF drafted the original manuscript. All other authors (BC, CPC, GG, JFH, RR, JC, MAR, KM) reviewed and edited the draft. TJB finalised the manuscript based on these revisions and suggestions. All authors have read and approved the final manuscript.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.