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“It's a burden, it's a nuisance. I wish I didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia

INTRODUCTION: People living with HIV (PLHIV) who use illicit drugs (other than or in addition to cannabis) are living longer due to antiretroviral therapy (ART). Older PLHIV who use drugs have an increased risk for comorbidities, and managing multiple health conditions is a growing concern among thi...

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Autores principales: Chayama, Koharu Loulou, Ng, Cara, Small, Will, Ivsins, Andrew, McNeil, Ryan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505831/
https://www.ncbi.nlm.nih.gov/pubmed/34636148
http://dx.doi.org/10.1002/jia2.25785
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author Chayama, Koharu Loulou
Ng, Cara
Small, Will
Ivsins, Andrew
McNeil, Ryan
author_facet Chayama, Koharu Loulou
Ng, Cara
Small, Will
Ivsins, Andrew
McNeil, Ryan
author_sort Chayama, Koharu Loulou
collection PubMed
description INTRODUCTION: People living with HIV (PLHIV) who use illicit drugs (other than or in addition to cannabis) are living longer due to antiretroviral therapy (ART). Older PLHIV who use drugs have an increased risk for comorbidities, and managing multiple health conditions is a growing concern among this population. However, in‐depth understandings of the lived realities and complexities of living with HIV alongside comorbidities among older PLHIV who use drugs remain limited. We sought to explore how older PLHIV who use drugs manage their comorbid conditions in a setting with universal ART access. METHODS: Between January 2019 and March 2020, semi‐structured, in‐depth interviews were conducted in Vancouver, Canada with 42 older PLHIV who use drugs and were living with at least one comorbidity. All participants were currently on ART, and had initiated treatment at least 2 years prior to the interviews. Data were analysed using inductive and deductive approaches. RESULTS: Several themes were identified through this analysis. First, comorbidities were perceived as more urgent health concerns and prioritized over HIV. Second, stigma and discrimination hindered access to care for comorbidities. Third, the concurrent management of HIV and comorbidities was often challenging due to unmanaged or poorly managed comorbidities. Fourth, the potential impact of ART on the development of comorbidities was a source of concern and frustration. Finally, integrated treatment approaches facilitated engagement with HIV and comorbidities care. CONCLUSIONS: Our findings underscore the need for HIV care to shift from a primary focus on managing HIV to an integrated, patient‐centred approach that addresses both HIV and non‐HIV‐related health needs, as well as an equitable and non‐judgemental delivery of such care for an ageing population of PLHIV who use drugs.
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spelling pubmed-85058312021-10-18 “It's a burden, it's a nuisance. I wish I didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia Chayama, Koharu Loulou Ng, Cara Small, Will Ivsins, Andrew McNeil, Ryan J Int AIDS Soc Research Articles INTRODUCTION: People living with HIV (PLHIV) who use illicit drugs (other than or in addition to cannabis) are living longer due to antiretroviral therapy (ART). Older PLHIV who use drugs have an increased risk for comorbidities, and managing multiple health conditions is a growing concern among this population. However, in‐depth understandings of the lived realities and complexities of living with HIV alongside comorbidities among older PLHIV who use drugs remain limited. We sought to explore how older PLHIV who use drugs manage their comorbid conditions in a setting with universal ART access. METHODS: Between January 2019 and March 2020, semi‐structured, in‐depth interviews were conducted in Vancouver, Canada with 42 older PLHIV who use drugs and were living with at least one comorbidity. All participants were currently on ART, and had initiated treatment at least 2 years prior to the interviews. Data were analysed using inductive and deductive approaches. RESULTS: Several themes were identified through this analysis. First, comorbidities were perceived as more urgent health concerns and prioritized over HIV. Second, stigma and discrimination hindered access to care for comorbidities. Third, the concurrent management of HIV and comorbidities was often challenging due to unmanaged or poorly managed comorbidities. Fourth, the potential impact of ART on the development of comorbidities was a source of concern and frustration. Finally, integrated treatment approaches facilitated engagement with HIV and comorbidities care. CONCLUSIONS: Our findings underscore the need for HIV care to shift from a primary focus on managing HIV to an integrated, patient‐centred approach that addresses both HIV and non‐HIV‐related health needs, as well as an equitable and non‐judgemental delivery of such care for an ageing population of PLHIV who use drugs. John Wiley and Sons Inc. 2021-10-11 /pmc/articles/PMC8505831/ /pubmed/34636148 http://dx.doi.org/10.1002/jia2.25785 Text en © 2021 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Chayama, Koharu Loulou
Ng, Cara
Small, Will
Ivsins, Andrew
McNeil, Ryan
“It's a burden, it's a nuisance. I wish I didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia
title “It's a burden, it's a nuisance. I wish I didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia
title_full “It's a burden, it's a nuisance. I wish I didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia
title_fullStr “It's a burden, it's a nuisance. I wish I didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia
title_full_unstemmed “It's a burden, it's a nuisance. I wish I didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia
title_short “It's a burden, it's a nuisance. I wish I didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia
title_sort “it's a burden, it's a nuisance. i wish i didn't have these other ailments”: a qualitative exploration of comorbidities management among older people living with hiv who use drugs in vancouver, british columbia
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505831/
https://www.ncbi.nlm.nih.gov/pubmed/34636148
http://dx.doi.org/10.1002/jia2.25785
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