The manual "HIV in the elderly"
The SME Development Fund presented a Manual on providing comprehensive medical and social care to older HIV patients
The Foundation for the Development of Intersectoral Social Partnership (SME Development Fund), with the support of the international biopharmaceutical company Gilead Sciences, has developed a Manual for conducting comprehensive medical and social support for patients with HIV infection of the older generation.
The purpose of the Manual is to raise awareness and provide medical and social workers, equal consultants with methodological and practical tools to improve the effectiveness of working with a category of patients over 50 years old who have HIV infection. Due to earlier "aging", HIV-infected people of the older generation are particularly susceptible to diseases, stress, social problems and discrimination, therefore, assistance should be provided in a comprehensive manner. The publication is designed to help various specialists learn not only to better understand the needs of older patients living with HIV, but also to acquire useful skills in interaction with colleagues.
The publication emphasizes the need for an individual approach to each patient, and in order to understand the different features of working with the target group, conditionally divides HIV-positive people aged 50 and over into 2 categories, each of which has its own needs.
The first group is people who learned about their diagnosis a long time ago (in the 1990s–2000s), received the necessary treatment and lived to an older age. This mainly includes the risk groups typical for the beginning of the epidemic: people who have taken injecting drugs in the past and their partners. Many of them have now changed their lifestyle thanks to social programs, which emphasizes the importance of an individual approach in working with such patients.
The second group is people who have been infected with HIV or have learned about their diagnosis recently, being already at an older age. Today, the infection has gone beyond the "risk groups": HIV can affect absolutely everyone, regardless of social status, while the main method of transmission of infection is sexual.
The authors of the Manual do not stop at these two categories, offering to study the individual needs of people depending on age, social status, physical and psychological condition. For example, at the age of 50, people are also in demand at work and lead an active lifestyle, but they may already face some health problems. After the age of 65, age-related diseases are often accompanied by financial difficulties and depression associated with the new status of a "pensioner" and a new attitude of society. All this directly or indirectly affects the effectiveness of HIV therapy and the fullness of life of people with a positive status. The manual offers to study in detail the categories of older patients and their real needs. It is easier for a socially successful person to maintain adherence to therapy and overall health than for a person with material, psychological or physiological problems.
An important aspect in providing medical care to older patients is the choice of the most appropriate treatment regimens. "Age-related" diseases in people with HIV infection often manifest earlier and require additional therapy. Despite the fact that modern antiretroviral drugs (ART) are devoid of pronounced side effects, it is important to take into account their compatibility with other medications taken by the patient and their impact on the development of certain diseases. The manual examines in detail the effect of ART on common diseases and the peculiarities of the action of various groups of drugs on people with age-related changes in the body.
The publication contains a detailed methodology and tools for organizing assistance services taking into account the characteristics of each patient – from attracting and assessing his needs to developing an individual support plan with the services of diverse services (social, public and medical organizations, charitable foundations, etc.). The authors are confident that comprehensive medical and social support for older patients will form a favorable an environment for a long, full and maximally healthy life with HIV, in the future strengthening trust in medical and social organizations.
Sergey Smirnov, representative of the SME Development Fund: "Almost all available approaches and methods of working with HIV-positive patients were developed at a time when the epidemic affected young people, and they were focused on working with them. Our Manual is the first experience of adaptation, generalization of knowledge and approaches to work with a target group of age-related patients and will be finalized with the development of practice. It is designed to improve the quality of service and become a reference point for those professionals who have difficulty working with people over 50 years old. When developing the Manual, we relied on the existing experience of working with older HIV-positive patients, their real stories, as well as surveys among patients and specialists. We tried to make it as applied as possible, not only describing in detail all the stages of interaction, but also offering ready-made questionnaires for surveys and checklists. I am sure that this Manual will contribute to improving the level of targeted care for age-related patients and its accessibility."
According to the Strategy for the Development of Healthcare in the Russian Federation for the period up to 2025 approved by the Decree of the President of the Russian Federation dated 06.06.2019, the creation of a modern system of medical care for older people is one of the priorities today. One of the key directions of the development of the Federal project "Development and implementation of the program of systemic support and improvement of the quality of life of citizens of the older generation "Senior generation" is to stimulate active longevity.
The manual is available on the Foundation's website.
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