Health care needs and services delivery for older persons with HIV/AIDS issues and research challenges

This article brings together information on age differences in HIV health care needs and use patterns to shed light on distinctive aspects of health services needs and use by older individuals with HIV. Age differences in social and economic characteristics, medical comorbidity, psychiatric comorbidity, survival, access to medical care, and patterns in use of inpatient services are examined. Existing literature suggests that delayed diagnosis, biologically based differences in progression of HIV disease, and comorbid health conditions unrelated to HIV all may contribute to the shorter time from diagnosis to death among patients. Event history analyses of the hazard and duration of hospitalization among individuals with AIDS in the New Jersey Medicaid program indicated that those age 50 and older were hospitalized somewhat less often but for longer stays, suggesting that there may be opportunities to substitute care at home for some care provided in the hospital to older people with HIV.