An observational study of comorbidity and healthcare utilisation among HIV-positive patients aged 50 years and over

Int J STD AIDS. 2016 Jul;27(8):628-37. doi: 10.1177/0956462415589524. Epub 2015 Jun 10.

Abstract

The number of HIV-positive people aged ≥50 years is rising each year. We measured the prevalence of non-infectious illnesses and their risk factors and described healthcare use in this UK population. A cross-sectional, observational study was conducted at an outpatient HIV specialist clinic in south east England. Patients age ≥50 years were invited to complete questionnaires measuring demographics, non-infectious illnesses, medication use, lifestyle and healthcare utilisation. The response rate was 67%. Of 299 participants, 84% reported ≥1 comorbid condition and 61% reported ≥2 (multimorbidity). Most commonly reported were high cholesterol, sexual dysfunction, hypertension and depression. In multivariate analyses, age, number of years HIV-positive and duration of antiretroviral therapy remained significant predictors of comorbidity when controlling for lifestyle factors (exercise, smoking and use of recreational drugs and alcohol). Use of non-HIV healthcare services was associated with increasing comorbidity, a longer duration of HIV and recreational drug use. The majority of HIV-patients aged ≥50 years reported multiple comorbidities and this was associated with polypharmacy and increased use of non-HIV services. Further research examining the quality, safety and patient experience of healthcare is needed to inform development of services to optimally meet the needs of older HIV-positive patients.

Keywords: AIDS; HIV; ageing; antiretroviral therapy; comorbid disease; elderly care; healthcare utilisation; multimorbidity.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiretroviral Therapy, Highly Active
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / epidemiology*
  • Drug Prescriptions / statistics & numerical data
  • England / epidemiology
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • Humans
  • Hypercholesterolemia / epidemiology*
  • Hypertension / epidemiology*
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Polypharmacy
  • Prevalence
  • Risk Factors
  • Sexual Dysfunction, Physiological / epidemiology*
  • Surveys and Questionnaires