Organizing HIV ageing patient care in South Africa: An implementation science approach.

Abstract

The role out of the efficient antiretroviral therapy in many countries as well as in South Africa has transformed HIV into a manageable chronic condition and has led to rising life expectancies among people living with AIDS. As a result, in Africa and elsewhere there was a number of reports on multiple comorbidities from non-communicable diseases in those living and aging with HIV.

We conducted a desktop review of studies conducted in South Africa and other countries on medical service administration and organization and planning of interventions aimed at people aging with HIV and acquiring non-communicable diseases due to aging. Furthermore, older adults with HIV have unique issues relating to medication compliance and are more likely to have issues like polypharmacy, cognitive impairment.

An approach to tackle these issues could be an integrated care instead of a specialized clinical approach. However, an integrated approach requires a strong commitment from all the parties, investment in patient and clinician education, relationship management among providers, services and funders. Furthermore, robust policy settings and appropriate infrastructure and capabilities of services needs further attention [1]. In the last decade, there is no doubt great progress has been made in extending services to HIV prevention, care and treatment, a substantial gap remains nevertheless in what we know is working and what we are really achieving with the various programs. To address this, we suggest the use of an implementation science framework to improve the efficiency and effectiveness of these programs. Policy- and decision-makers in South Africa and other parts of Africa will thus require putting further concerted efforts and greater emphasis on targeted care for older adults.