1. HIV, Aging, and Advance Care Planning: Are We Successfully Planning for the Future?
- Author
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Erlandson, Kristine M., Allshouse, Amanda A., Duong, Syki, MaWhinney, Samantha, Kohrt, Wendy M., and Campbell, Thomas B.
- Subjects
ACADEMIC medical centers ,AGE distribution ,AGING ,AIDS ,CHI-squared test ,CONFIDENCE intervals ,EPIDEMIOLOGY ,HEALTH surveys ,HIV-positive persons ,RESEARCH funding ,SCALES (Weighing instruments) ,SEX distribution ,STATISTICS ,ADVANCE directives (Medical care) ,LOGISTIC regression analysis ,DATA analysis ,CROSS-sectional method ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Introduction: Studies of advance care planning (ACP) completion rates in HIV-infected persons pre-date the 'graying' of the HIV epidemic. We sought to examine current ACP completion rates and factors influencing completion among HIV-infected persons. Methods: HIV-1-seropositive persons aged 45-65 years on effective antiretroviral therapy for a minimum of 6 months were enrolled in a cross-sectional survey. Likelihood of ACP was assessed by demographic and clinical characteristics, tested with odds ratios (OR) and 95% Wald confidence intervals (CI), and adjusted for gender. Results: Of 238 participants, 112 (47%) completed ACP. Persons ≥55 years of age (OR 2.8; CI 1.6,5.0; p<0.001), males (OR 4.1; CI 1.8,9.3; p=0.004), and persons with higher education (OR 2.2; CI 1.3,4.0; p=0.007) were more likely to have completed ACP. Persons with a cardiac event were more likely to have completed ACP (OR 5.5; CI 1.6,25; p=0.03), although this effect was diminished after adjusting for gender (OR 4.5; CI 0.95,21.4; p=0.06). HIV infection diagnosed for greater than 5 years was not associated with ACP completion (OR 1.3; CI 0.7,2.7; p=0.4). Current CD4
+ cell counts were similar between those completing and not completing documentation (588 cells/μL and 604 cells/μL, respectively; p=0.7). The likelihood of ACP did not significantly differ with other comorbidities. Discussion: Less than 50% of middle-aged patients in HIV care had documented ACP. In particular, women and those with lower education were at greatest risk of non-completion and may need interventions to improve ACP. [ABSTRACT FROM AUTHOR]- Published
- 2012
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