Department of Surgical, Medical, Dental and Morphological Sciences.
Modena HIV Metabolic Clinic (MHMC), University of Modena and Reggio Emilia.
Curr Opin HIV AIDS. 2023 Mar 1;18(2):111-115. doi: 10.1097/COH.0000000000000785.
This perspective paper offers some reflections on an hypothesized changing scenario of HIV comorbidities in the years to come and provides some insights on how to improve screening and management of people with HIV (PWH) in the coronavirus disease 2019 (COVID-19) era.
PWH may experience a higher burden of excess disease and mortality associated with noninfectious comorbidities in the COVID-19 era. HIV care must move beyond viral-immunological success to incorporate patient-centered outcomes based on the intrinsic characteristics of the individual and its environment, assessment and screening for comorbidities, evaluation of aging and geriatric syndromes and last but not least fight stigma, ageism and inequality to access to care.
COVID-19 is widening the gap between unmet needs of PWH and healthcare systems. An increasing burden of comorbidities, multimorbidity and frailty is affecting PWH which requires redesign of care delivery oriented around the diverse needs of individuals, rather than the prerequisites of providers, and must ensure health equity. In particular, any changes to care delivery must address existing disparities in access and care among PWH and fight stigma.
本文对未来几年 HIV 合并症假设变化的情况进行了一些反思,并就如何在 2019 冠状病毒病(COVID-19)时代改善 HIV 感染者(PWH)的筛查和管理提供了一些见解。
PWH 在 COVID-19 时代可能会面临更高的非传染性合并症相关疾病负担和死亡率。HIV 护理必须超越病毒免疫成功,纳入以个体内在特征及其环境为基础的以患者为中心的结局,对合并症进行评估和筛查,评估衰老和老年综合征,最后但并非最不重要的是消除耻辱感、年龄歧视和不平等,以获得护理。
COVID-19 扩大了 PWH 的未满足需求与医疗保健系统之间的差距。合并症、多种合并症和虚弱的负担不断增加,影响了 PWH,这需要围绕个人的多样化需求重新设计护理提供方式,而不是提供者的先决条件,并必须确保卫生公平。特别是,任何护理方式的改变都必须解决 PWH 中现有的获得护理和护理方面的差距,并消除耻辱感。