HIV: The Long View

What actions do we need to take in order to improve and secure the long-term health of people living with HIV, particularly beyond viral suppression as the primary goal, and those individuals at risk for HIV? Analyzing evidence-based science in a new report, a coalition of advocates and stakeholders have come together to make recommendations about potential trends in HIV care and management in the United States over the next two decades. The result is HIV: The Long View.

The HIV: The Long View coalition includes the American Academy of HIV Medicine, HealthyWomen, National Council on Aging, National Black Leadership Commission on AIDS, and Gay Men’s Health Crisis. Gilead Sciences is its partner and sponsor. The data and research was provided by Future Foundation (FF), an independent global consumer trends and insight firm, who reviewed the medical literature, and conducted a consumer survey and one-on-one interviews with multidisciplinary healthcare experts.

lvusinfogram1“HIV is perhaps the most ruthless public health crisis the world has ever faced, and while the most immediate, life-threatening challenges have evolved in developed nations, we cannot lose sight of the fact that the epidemic continues to grow, even in well-resourced areas,” said Kelsey Louie, Chief Executive Officer, Gay Men’s Health Crisis, in a prepared release. “If we are going to meaningfully advance HIV education, prevention, treatment and care, it will be due to multidisciplinary collaborations like HIV: The Long View that identify and strive to help work through the complex socioeconomic and healthcare factors that currently deny a long-term healthy future to many people living with and at risk for HIV.”

The report highlights a streak of optimism in American consumers, who hypothesize that, in two decades’ time we will have almost complete access to affordable, high-quality medical care; personalized medicine will become more pervasive alongside a consistent, ongoing analysis of real-time patient data via algorithms applied to electronically stored information; preventive medicine technology, such as mobile health apps, telemedicine, and self-diagnosing devices, will be a regular method to help individuals stave off chronic conditions like obesity, cancer, kidney disease, and diabetes, all of which are on the rise; chronic diseases and aging-related conditions will still be a significant challenge; and, while research advances could potentially bring an end to the most pernicious infectious diseases, we still need to remember that innovative treatments and cures must be developed.

lvusinfogram2The Coalition interpreted the data through the lens of HIV care and management and arrived at key recommendations, related to healthcare affordability and access, new preventive medicine technology, connecting those who test positive immediately to care, addressing challenges related to personalized HIV medicine, and HIV and aging-related conditions.

Let’s look at the recommendations for aging-related conditions, quoted in full here, as this population is growing but very often underserved:

• The healthcare system, policy makers and patients must work toward an integrated care model for people with HIV, one in which healthcare professionals treat the whole person, not just his or her HIV viral load. Integration with HIV community groups and services can also play an important role.

• Primary care providers will need training to become proficient in HIV prevention counseling, as well as HIV testing and treatment. Additionally, more providers will need to be trained as HIV specialists.

• Research is needed to understand the relationship between HIV, inflammation, aging and the risk of chronic conditions.

• Quality of life measures for individuals living with or at risk for HIV must be developed, tested and validated before they can be deployed.

• People with HIV need more information about their increased risk of chronic conditions (such as high blood pressure, brittle or weak bones, obesity, kidney and liver disease and certain forms of cancer) and methods to manage them. They should also be aware that the long-term effects of aging on these chronic conditions in people with HIV is relatively unknown.

• Improve information sharing among healthcare providers and develop and maintain care and treatment guidance around clinical issues related to persons aging with HIV.

• Improve education for those age 55+ on the risk of contracting HIV.

Overall, the Coalition’s calls to action include the complete dismantling of stigma related to sex, sexual health and HIV status; ending the “one size fits all” approach to HIV prevention, treatment, and education and adopting tailored approaches; culling HIV patient data to improve personalized medicine; educating and empowering everyone to stay on top of their health to prevent or delay the development of chronic conditions; and championing the 100-percent adoption of evidence-based guidelines across every U.S. healthcare practice to ensure patient prevention counseling and care access, regular testing, as well as HIV care engagement and retention.

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