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Aging and Chronic Conditions Among People with HIV

As HIV treatment and support services advance and become accessible, more people with HIV have long and full lives. Life expectancy is nearly the same for people with HIV who are engaged in HIV care and for people without HIV. Most people with HIV are 50 and older.

For many people with HIV, growing older can come with new challenges for health, daily living and quality of life. People with HIV have chronic conditions more often than people without HIV and often at younger ages. Chronic conditions that commonly affect people with HIV are diabetes, chronic kidney disease, cognitive decline disorders, bone density loss and some cancers. These conditions can affect parts of life like memory, mobility, social and emotional wellness, and cost of medical care and medications. Chronic conditions are often treatable or manageable, particularly when these conditions are diagnosed early and for those with strong networks of support.

Planning and access to community resources can help people with HIV tackle issues that growing older may bring. People with HIV can talk with peers and case managers about insurance and long-term care plans, building financial security, growing strong connections with community and how to talk about chronic conditions with their providers.

Information for Providers

There are programs to help providers respond to the changing needs of people with HIV as they age including:

Clinicians can support progress toward population health equity by:

  • Ensuring clinical guidance is incorporated into practice.
  • Deploying data and technology-supported quality improvement methods for chronic conditions screening and care outcomes.
  • Providing services that respond to challenges affecting people with HIV as they age.
  • Leveraging state-level technical assistance resources.

Case managers and other program staff can support progress toward population health equity by:

  • Facilitating client access to community services that respond to the needs of older adults, such as local Area Agencies on Aging, Program of All-Inclusive Care for the Elderly (PACE) and senior centers.
  • Enhancing capacities to provide client navigation for Medicare insurance and Social Security.

Clinical and non-clinical providers can contact Trevor Strzyzykowski to discuss efforts and opportunities to address issues affecting older adults with HIV.

Programs

HIV-Associated Neurocognitive Disorder, Alzheimer’s Disease and Related Dementias

The Alzheimer's Association-Michigan Chapter provides free support and resources to people living with HIV and HIV-Associated Neurocognitive Disorder (HAND), dementia or who are concerned about their brain health. Resources offered to people with HIV include physician referrals, support group recommendations, and information about coping strategies and planning for the future.

The program provides consultation and informational resources to Ryan White funded agencies for developing and implementing quality improvements that address cognitive decline conditions that affect people with HIV.

Contact David Hind at 248-996-1060 or DVHind@alz.org to learn more about this program.

Resources

  • Providers can offer information about the Alzheimer’s Association programs and services to clients, which are free and available in the safety of their home. Visit Alzheimer's Association Education and Resources to view all offerings clients can access, including a 24/7 helpline, group education, care consultation and social engagement programs. For more information, email helplinegmc@alz.org or call the Alzheimer’s Association Greater Michigan Chapter’s Helpline at 800-272-3900.
  • HIV and Cognitive Dysfunction Toolkit for Professionals
    This toolkit includes resources from the Alzheimer's Association and Michigan Alzheimer's Disease Resource Center. The resources provide information on Alzheimer's disease and other dementias, screening for cognitive disorders and information for patients on how to get additional support.
  • Improving Cognitive Decline Among People with HIV in Michigan
    This brief is an overview of how cognitive decline affects people with HIV, key clinical and community practices that support improving care for people with HIV, clinical features of HAND and resources available to Ryan White providers in Michigan.

Cancer Screening Project (CaSPr)

The Cancer Screening Project (CaSPr) accepts physician referrals to provide free coordination and navigation services for the screening of colorectal, cervical, breast (chest) and lung cancers for people with HIV in Michigan. Nearly all clients who have received CaSPr navigation services have received cancer screenings.

CaSPr also responds to provider and client requests for information relating to cancer screening resources in Michigan. For example, many people have called CaSpr to ask questions like:

  • What is the schedule for the traveling mammogram bus? 
  • Is there a primary care provider (PCP) with experience screening people like me for cervical cancer? 
  • Can you help link screening resources with PCPs?

The CaSPr page contains information for community members and providers including:

  • Complete information on CaSPr programs and how to refer to CaSPr.
  • Recommendations on breast (chest), cervical, colorectal and lung cancer screening.
  • Factors affecting chances of developing different cancers.
  • Data dashboards.

Contact the CaSPr Navigator for questions about this program at 517-512-5041.


Diabetes and Chronic Kidney Disease

Diabetes clinicians and public health experts provide technical assistance and support to screen for and address diabetes and/or chronic kidney disease (CKD) within clinics. This includes providing assistance to utilize electronic health record information to identify clients who may have or be at a higher likelihood for diabetes or CKD, establishing referral processes for these clients, and identifying and implementing clinic/site-based programs to address chronic conditions. The MDHHS Diabetes Team works with clinics to integrate new efforts into existing Ryan White programming and to identify resources for clients who may benefit from additional resources.

Contact Lauren Neely at NeelyL1@michigan.gov to learn more about this program.

Resources