People with HIV are now living longer, thanks to combination antiretroviral therapies. But new infections are on the rise among older adults too. This trend will culminate in the next few years with over half of all people with HIV in North America, Europe and Australia being over the age of 50.
For this reason, it is important to know what is out there in Canada in terms of HIV and aging-related programs and services, and how HIV organizations and clinics are meeting the needs of the older Canadians they serve.
In an attempt to answer this question, a survey of HIV and aging programs and services in Canada was conducted in 2013 at the request of the National Coordinating Committee on HIV and Aging. This survey, HIV and Aging: An Environmental Scan of Programs and Services in Canada, was guided by a team consisting of older people with HIV, service providers, policy analysts, and researchers (full disclosure: I was a member). The organizations who responded included community-based HIV organizations (historically called AIDS service organizations), HIV specialty clinics and community health centres.
What is out there in terms of HIV and aging-related programs and services being offered by HIV organizations across Canada?
Representatives from over half of all organizations the team heard from, and 75% of community-based HIV organizations, said that HIV and aging is a priority for their agencies and that they are attempting to address the needs of older people with HIV who have traditionally looked to their organizations for support.
Across Canada, the study team identified 21 unique, promising programs designed to meet the needs of older people with HIV, with others in development. These programs mostly focus on work in four areas: health, home care and practical support programs; support groups and peer-led support initiatives; informational and educational programs; and national coordination activities.
While many organizations do not have such programs in place yet, it is clear that service providers are making a concerted effort to address gaps in their own programming through extensive referral networks. The study team concluded that changing needs, available funding and champion-initiated advocacy largely drive development and adaptation of programs and services for older Canadians with HIV.
How are community-based HIV organizations and HIV clinics meeting the needs of older Canadians with HIV?
While these organizations are prioritizing approaches that respond to demographic changes in their respective communities, they are adapting existing programs and developing new ones to address the challenges of HIV and aging. They are doing this not only by delivering tailored programs of their own but also by fostering cross-sectoral collaboration with aging-focused service providers; educating key players about the impact of HIV on the aging process; examining the end-of-life care needs of older people with HIV; offering more routing screening for comorbidities that are common in aging; supporting chronic disease management efforts, especially through peer support initiatives; and modifying existing housing models to increase support for activities of daily living. These changes are being made in consultation with older people with HIV, despite limited resources and diverse needs.
What are the promising practices, gaps and barriers?
While it was beyond the scope of the survey to evaluate the efficacy or impact of existing HIV and aging programs, the study team did identify promising types of services and promising ways of delivering these services. It also identified common barriers to planning and delivering HIV and aging programs. The team also made some recommendations to stimulate thought and discussion among individuals and organizations serving older people with HIV.
What are the next steps?
The study team hopes that its survey will have a resonant impact, whether it leads to new partnerships, increases referrals, raises awareness of existing programs or informs the development of new programming for older Canadians with HIV.
You can download and read a full copy of the community report of this survey here.
Brief descriptions of each of the 21 unique HIV and aging-related program and services identified by the survey are outlined in a companion “living”document that is regularly reviewed and updated to ensure that new program examples are shared. This document can be accessed here.
If you would like more information or wish to contribute your ideas for the further development of programming for older people with HIV, you are invited to contact:
Kate Murzin, Health Programs Specialist
The Canadian Working Group on HIV and Rehabilitation