The 130th Annual Meeting of APHA

Abstract #45060

Lisa R. Hirschhorn, MD, MPH¹, Laureen M. Kunches, RN, CS-ANP, MPH², Nancy Reinhalter¹, JB Decristofaro, RN¹, Joseph Musolino¹, and Jean Flatley McGuire, PhD³. (1) JSI Research and Training Institute, 44 Farnsworth Street, Boston, MA 02210, 617-482-9485, lhirschhorn@jsi.com, (2) Brandeis University and JSI Research and Training Institute, 44 Farnsworth Street, Boston, MA 02210, (3) MA Dept. of Public Health HIV/AIDS Bureau, 250 Washington Street, Boston, MA 02108

The population of PLWHOF is growing as survival improves and transmission continues. Older age is associated with decreased survival and lower CD4 count responses, yet little is still known about care of PLWHOF.

Using data from the Massachusetts ACTNOW Quality Assurance Project, we examined epidemiology and patterns of care at 17 clinical sites in 1999 and 2000. Data was extracted by chart reviews of a random sample of patients at each site (1100 total). All p values are <.05 unless otherwise noted

Demographics between older and younger PLWH were similar, but PLWHOF were more likely to be male (but not MSM risk), have AIDS, and have CD4 remain <200 (p=.08) and less likely to have active substance abuse. PLWHOF were more likely to receive pneumovax, with similar rates of Pap smear, TB and HCV screening, but lower rates of risk reduction counseling. Similar rates of antiretroviral therapy (ART) were seen, with PLWHOF less likely to interrupt ART or have adherence problems, and more likely to always have undetectable viral load (p=.09). They were more likely to die during the year (7% vs 4%, p=.08)

While most demographics and care were similar to younger patients, PLWHOF had more advanced disease, and although less likely to stop or not adhere to ART, more had CD4 remain <200. In addition, despite ongoing risk, PLWHOF were less likely to receive risk reduction counseling. Continued work on differences in needs, response to treatment and attention to ongoing risk are critical to provide more effective care.

Learning Objectives:

At the end of the presentation, attendees will be able to
• Understand the epidemiology and patterns of care older individuals living with HIV/AIDS in Massachusetts
• Identify areas for improvement in care and effective treatment of this population
• Understand the differences between younger and older individuals living with HIV/AIDS

Keywords: HIV/AIDS, Elderly

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.