HIV Care Needs to Focus on Long-Term Well-Being of Patients

HIV infection has become a chronic and manageable condition. The focus must now shift towards long-term well-being, comprehensive care for multiple health conditions (multimorbidity), and an emphasis on maintaining a good quality of life for people living with HIV. This is one of the key messages of a comprehensive review of HIV infection by ISGlobal researcher Jeffrey V Lazarus and colleagues in Nature Reviews Disease Primers. These reviews offer a global overview of a disease and are considered a highly valuable resource for students, researchers and clinicians entering the field.

An overview of HIV progress, challenges and hope

“The battle against HIV/AIDS has come a long way, from a time of fear and uncertainty to one of hope and progress,” says Lazarus, head of the Health Systems Research Group at ISGlobal, an institution supported by “la Caixa” Foundation. The development of rapid diagnostics and effective antiretroviral therapies (ART) have significantly reduced HIV mortality. ART-mediated viral suppression not only enhances health outcomes but also eliminates the sexual transmission of the virus. This huge progress has created a growing community of individuals who can lead fulfilling lives with adequate medical care and support.

However, Lazarus and colleagues stress three key messages. First, the need to ensure that prevention and treatment are available, affordable and accessible for all. Second, the need to focus on the long-term well-being and quality of life of these patients. Indeed, people living with HIV have an increased risk of other diseases, such as neurocognitive disorders, lung disease or cardiovascular disease. The third message is that, to bring the epidemic to an end, further work is needed to develop an effective and affordable vaccine as well as a functional cure.

Going forward with a person-centered approach

In a special issue of the Journal of the International AIDS Society (JIAS) edited by Lazarus and two other renowned experts, a series of articles show that health systems where patient and community needs, rights and preferences are put first results in higher retention in care and HIV outcomes. These people-centred approaches require meaningful and sustained engagement between the different stakeholders, co-designed strategies, and a systemic shift to address inequities and remove barriers to care.

“Person-centred care models for people living with HIV are still scarce, but this issue proves that healthcare systems can and are working towards more equality and trust, centring on patients, their families and communities,” says Lazarus.

References:

Bekker LG, Beyrer C, Mgodi N et al. HIV infection. Nature Reviews Disease Primers, 9, 42 (2023). Doi: 10.1038/s41572-023-00452-3.

Person‐centred approaches to address the health needs of people living with HIV and co-morbidities. Guest Editors: Jeffrey V. Lazarus, Georgina Caswell, Rena Janamnuaysook. JIAS. Volume 26, Issue S1.