Special consideration for users living with HIV must be taken

Topics covered: Ridouts professional advice

The most recent report into HIV in the United Kingdom from Public Health England has indicated that one in four people living with HIV are over 50, a dramatic difference compared to the figures from even a decade ago where it was one in eight. This increase is due partly to both more people being diagnosed as a result of more public awareness, as well as a reflection to the vast leaps we have made in the treatment of HIV. With the help of modern treatment can now expect to live into their 70s, a significant improvement of 16 years upon treatment from a decade ago. With the marvels of modern medicine and care, this is clearly something to celebrate.

However, on the other side of the fence, this population of HIV positive people going into care is inducing a growing challenge that care homes and workers must address, as the responsibility for everyday treatment and concerns are handed over. Despite the great strides made in the field of HIV treatment, at its core the effects of HIV on both the immune system and health of those who have it when compounded with the effects growing old means that they are at greater risk of health complications. Although we have yet to know the full impact of prolonged HIV treatment, as well as it’s interaction with other medication, there is significant evidence that people living with HIV are more likely to “prematurely age”, and more at risk with associated chronic conditions such as cardiovascular disease, arthritis and dementia at an earlier time. One study showed that in a group of those living with HIV over the age of 50, nearly two thirds were on treatment for other long term conditions- nearly double when compared to what would be expected in a similar group without. To reflect this increased risk of complications, care homes should seek to be more attentive and alert in the care of those with HIV.

It is not purely in the medical aspects and treatment of HIV that concerns arise. One of the main aims of care providers is to create and maintain a setting where people are able to adjust from the transition of their own homes to a residential care and be at ease, both with their surroundings, as well as other service users and care workers. However, for those people living with HIV, this may sometimes be harder to achieve, for fear of discrimination and uninformed prejudices. Surveys have shown that some gay and bisexual men are anxious about accessing care, concerned that they may face homophobia or feel obliged to be secretive about their relationships, and there have been stories of burgeoning relationships being quashed by staff who don’t know how to address such cases. Furthermore, the situation gets more complex when the majority of other elderly service users come from a comparatively less liberal time, with their views tinted from the past. For black African men and women, whose community have been disproportionately affected by HIV, there have been concerns about finding culturally sensitive services, free from any experiences of racism and homophobia. When one considers this in addition to the stigma and discrimination experienced already by people living with HIV, it seems apparent that care providers who wish to meet the needs of those living with HIV must first do some prior preparation and additional planning.

Sometimes, it is not just other service users that threaten the quality of care people living with HIV deserve, but instead the actual staff and workers. Work carried out by the National Aids Trust seems to suggest that some people in the health and care sector have not kept up with the fast changing field of HIV, with this lack of update information resulting in prejudice and uninformed misunderstandings. This may translate into severely unprofessional behaviour, whether that be out of a misplaced sense of safety and infection control, with workers refusing to give people living with HIV baths, disposable cutlery, and even disclosing their status and warning everyone, whereas in reality there is no risk of HIV transmission from the day to day activities of care. This lack of knowledge of information and beliefs with no scientific basis results in avoidable yet severe distress from those involved, but could be addressed easily by care homes by educating their staff and workers.

This is a new challenge that will not just go away. As advances in HIV treatment continues, more and more people living with HIV will be reaching that stage in life where they will go in care, and a change in attitude and consideration should be undertaken by care homes to reflect that.

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