Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA; and.
DLH Corporation, Atlanta, GA.
J Acquir Immune Defic Syndr. 2024 Apr 1;95(4):318-328. doi: 10.1097/QAI.0000000000003365.
Approximately 2 in 5 persons with HIV (PWH) in the United States are aged 55 years or older. HIV ancillary services, such as case management and transportation services, can help older PWH remain engaged in care. We used data from the Medical Monitoring Project (MMP) to describe the prevalence of unmet needs for ancillary services among persons with diagnosed HIV aged 55 years or older.
MMP is an annual cross-sectional study that reports representative estimates on adults with diagnosed HIV in the United States.
We used MMP data collected during June 2019-May 2021 to calculate weighted percentages of cisgender men and cisgender women with HIV aged 55 years or older with unmet needs for ancillary services, overall and by selected characteristics (N = 3200). Unmet need was defined as needing but not receiving a given ancillary service. We assessed differences between groups using prevalence ratios (PRs) and 95% confidence intervals with predicted marginal means.
Overall, 37.7% of cisgender men and women with HIV aged 55 years or older had ≥1 unmet need for ancillary services. Overall, 16.6% had ≥1 unmet need for HIV support services, 26.9% for non-HIV medical services, and 26.7% for subsistence services. There were no statistically significant differences in unmet needs for services by gender. The prevalence of ≥1 unmet need was higher among non-White persons (PR range: 1.35-1.63), persons who experienced housing instability (PR = 1.70), and those without any private insurance (PR range: 1.49-1.83).
A large percentage of older PWH have unmet needs for ancillary services. Given the challenges that older PWH face related to the interaction of HIV and aging-associated factors, deficits in the provision of ancillary services should be addressed.
在美国,约有 2/5 的 HIV 感染者(PWH)年龄在 55 岁及以上。辅助服务(如病例管理和交通服务)可以帮助老年 PWH 继续接受治疗。我们使用来自医学监测项目(MMP)的数据来描述诊断为 HIV 的 55 岁及以上人群中辅助服务未满足需求的流行率。
MMP 是一项年度横断面研究,报告了美国诊断为 HIV 的成年人的代表性估计数。
我们使用 MMP 在 2019 年 6 月至 2021 年 5 月期间收集的数据,计算了患有 HIV 的 55 岁及以上的顺性别男性和女性中,总体以及按选定特征(N=3200)划分的辅助服务未满足需求的加权百分比。未满足的需求被定义为需要但未获得某项辅助服务。我们使用预测边际均值评估了不同组之间的差异,使用患病率比(PR)和 95%置信区间进行评估。
总体而言,37.7%的患有 HIV 的 55 岁及以上的顺性别男性和女性有≥1 项辅助服务未满足需求。总体而言,16.6%有≥1 项 HIV 支持服务未满足需求,26.9%有非 HIV 医疗服务未满足需求,26.7%有生存服务未满足需求。按性别划分,服务未满足需求方面没有统计学上的显著差异。未满足需求的患病率在非白人(PR 范围:1.35-1.63)、经历住房不稳定(PR=1.70)和没有任何私人保险的人群中更高(PR 范围:1.49-1.83)。
很大比例的老年 PWH 有辅助服务未满足需求。鉴于老年 PWH 面临与 HIV 和与年龄相关的因素相互作用的挑战,应解决辅助服务提供不足的问题。