Realize, Toronto, Ontario, Canada.
Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.
J Int AIDS Soc. 2022 Sep;25 Suppl 4(Suppl 4):e25978. doi: 10.1002/jia2.25978.
INTRODUCTION: The population of people living with HIV (PLWH) is ageing consequent to effective treatment and a steady stream of new diagnoses among older adults. PLWH experience a greater burden of age-related comorbidities and poorer social determinants of health compared to their HIV-negative peers, yet comprehensive requisites for care and support as PLWH age remain poorly understood. Preferences And Needs for Ageing Care among HIV-positive Elderly people in Ontario, Canada (PANACHE ON), explored the health and community care and social support needs and preferences of a diverse group of older PLWH (age 60+) and described life course experiences among older PLWH that shape these needs and preferences and whether they are met. METHODS: PANACHE ON was a qualitative community-based participatory research study. In-person focus groups using a semi-structured interview guide were co-facilitated by pairs of trained older PLWH from July to October 2019. Purposive sampling bolstered the inclusion of communities disproportionately affected by HIV in Ontario. Descriptive analysis was used to summarize demographic data; participatory data analysis was conducted by a subset of the research team, with transcripts double-coded and analysed using NVIVO 12 Plus. RESULTS: A total of 73 PLWH participated, 66% identified as men. The mean age was 64 years (range 55-77) and median time living with HIV was 23 years (range 2-37). The current and anticipated needs of older PLWH, many of which were only partially met, included necessities such as food and housing, mobility and sensory aids, in-home support, social and emotional support, transportation and information. Three experiences-trauma, stigma and uncertainty-intersected in the lives of many of our participants, shaping their needs for care and support, and impacting the ease with which these needs were met. CONCLUSIONS: Unmet health and social needs and limited control over the availability and accessibility of ageing-related care and support due to resource constraints or reduced capacity for self-advocacy results in anxiety about the future among older PLWH, despite their well-developed coping strategies and experience navigating systems of care. These study findings will inform the development of the first national needs assessment of older PLWH in Canada.
简介：由于有效治疗和新诊断病例在老年人群中的持续出现，艾滋病毒感染者（PLWH）的人口正在老龄化。与 HIV 阴性同龄人相比，PLWH 面临更大的与年龄相关的合并症负担和较差的健康社会决定因素，但随着 PLWH 年龄的增长，对其综合护理和支持需求仍了解甚少。加拿大安大略省艾滋病毒阳性老年人的偏好和老龄化护理需求（PANACHE ON）研究了一组多样化的老年 PLWH（60 岁以上）的健康和社区护理以及社会支持需求和偏好，并描述了塑造这些需求和偏好的老年 PLWH 的人生历程经验，以及这些需求和偏好是否得到满足。
方法：PANACHE ON 是一项基于社区的定性参与式研究。2019 年 7 月至 10 月，由经过培训的老年 PLWH 对以半结构化访谈指南进行的面对面焦点小组进行共同主持。通过有目的的抽样，增加了安大略省受 HIV 影响不成比例的社区的包容性。描述性分析用于总结人口统计学数据；参与式数据分析由研究团队的一部分进行，使用 NVIVO 12 Plus 对转录本进行双编码和分析。
结果：共有 73 名 PLWH 参与，其中 66%为男性。平均年龄为 64 岁（范围 55-77 岁），中位感染艾滋病毒时间为 23 年（范围 2-37 年）。大多数仅部分得到满足的老年 PLWH 的当前和预期需求包括食物和住房、移动和感官辅助、家庭支持、社会和情感支持、交通和信息等必需品。创伤、污名和不确定性这三种经历在我们的许多参与者的生活中交织在一起，塑造了他们对护理和支持的需求，并影响了这些需求的满足程度。
结论：由于资源限制或自我倡导能力下降，导致与年龄相关的护理和支持的可用性和可及性不足，导致老年 PLWH 对未来感到焦虑，尽管他们有成熟的应对策略和管理护理系统的经验，但仍存在未满足的健康和社会需求。这些研究结果将为加拿大制定第一项全国性的老年 PLWH 需求评估提供信息。
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