"Call 911 - That's my [Advance Care] Plan": Factors that Inform Advance Care Planning Conversation Readiness Among Aging Persons Living With HIV.
Emily Pinto TaylorSean N HalpinVincent C MarconiAmy C JusticeTheodore M JohnsonD Keith McInnesMolly M PerkinsPublished in: Journal of applied gerontology : the official journal of the Southern Gerontological Society (2024)
Antiretroviral therapy has dramatically increased the lifespan of people living with HIV (PLWH), but advance care planning (ACP) and hospice services are underutilized in this population. The purpose of this study was to understand barriers and facilitators to ACP among this group. PLWH ( n = 25) were recruited from an HIV Clinic at a Veterans Affairs (VA) Medical Center in Atlanta, GA to represent a range of sociodemographic characteristics and experiences. Semi-structured interviews were analyzed using thematic analysis. More than half of participants (64%) indicated not engaging in ACP. We identified four key barriers to ACP: (1) a self-image among PLWH as "survivors" (and a reluctance to think about ACP); (2) a history of mistrust and mistreatment; (3) weak social ties and a desire to avoid disclosure of HIV status; and (4) a value for self-reliance. Findings have important implications for interventions to overcome these barriers.
Keyphrases
- antiretroviral therapy
- advance care planning
- hiv infected
- hiv positive
- human immunodeficiency virus
- hiv aids
- healthcare
- hiv infected patients
- palliative care
- mental health
- hiv testing
- men who have sex with men
- primary care
- pet ct
- deep learning
- south africa
- pain management
- young adults
- affordable care act
- health insurance
- machine learning