142nd APHA Annual Meeting and Exposition

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Aging and HIV infection: Case studies detailing one family's multigenerational experience with HIV infection

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Patricia Kloser, MD, MPH, FACP , Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ
Case studies were developed for three generations of women, all of whom were diagnosed with HIV infection, and received some form of antiretroviral (ARV) treatment. Laboratory findings associated with HIV therapy in the daughter and granddaughter included CD4 counts of greater than 500 cells/mm3 and undetectable viral loads. However, while the grandmother’s CD4 count was consistently in 400 cells/mm3 to 500 cells/mm3 range, her viral load was detectable, and she choose to remain on monotherapy, despite the treatment successes experienced by her daughter and granddaughter. Comorbid conditions and treatment side effects were presented, as these were related to grandmother’s decision to remain on monotherapy. In spite of what many clinicians might determine to be a less than satisfactory treatment outcome, the grandmother has been described as a long term survivor of HIV infection, and the experiences and support system shared by these women have contributed to their excellent health status, even in the presence of HIV infection. Since the women received their health care from the same physician based at an urban university-based hospital, factors related to continuity of care and a holistic care focus were also examined and reported. As more individuals with HIV infection live longer and experience the aging process, clinicians, researchers and program developers must incorporate their unique health challenges into standards of care and programs to address their needs. Finally, much can be learned about chronic illness throughout the lifespan by examining the multigenerational experiences of families affected by HIV infection.

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health

Learning Objectives:
Explain the nature of HIV infection as a lifespan challenge, as well as a chronic disease Discuss the case studies of three generations of women with HIV infection: grandmother in her 80s, midlife daughter and granddaughter Identify similarities and differences among the characteristics of these women Describe the multigenerational influences on these women with respect to HIV treatment and outcomes Discuss how the experiences of this family can be incorporated into standards of care for aging individuals with HIV infection

Keyword(s): Aging, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As Founder of the Newark Women’s AIDS Clinic (NWAC) and Medical Director, Infectious Disease Clinic, Ambulatory Care at the University of Medicine & Dentistry of New Jersey, I provided direct care to individuals with HIV infection and served as Principal Investigator on industry and government sponsored research studies in the areas of HIV/AIDS and women’s health. In addition, I am a Clinical Professor in the Department of Medicine at Rutgers-New Jersey Medical School.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.