People Living With HIV in U.S. Nursing Homes in the Fourth Decade of the Epidemic.
Brianne Olivieri-Mui, Jean McGuire, Sean Cahill and 2 others
PMID 30586081WHAT IT FOUND
Medicare-eligible nursing home residents with HIV were mostly admitted from acute hospital care. 20.9% received no ART, 34.7% had depression, and 97.1% had no psychotherapy in the past week.
Key findings
01Of 7,188 analyzed nursing home residents with HIV, 93% were admitted from an acute hospital stay.
0220.9% of the population received no ART, and 8% received a regimen not recommended by DHHS.
03Depression was reported in 34.7% and anxiety in 17.5%, but 97.1% received no psychotherapy in the past week.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was limited to Medicare-eligible residents linked to a nationwide prescription dispensing database, so private-pay residents were not included. Prescription records may not capture fills outside the pharmacy provider, and HIV status was inferred from diagnosis codes or ART prescriptions rather than confirmed for some cases. The resident assessment may under-report some characteristics, and several variables were not comparable with the older data. The study did not compare residents with HIV with the general nursing home population, and did not measure duration of HIV or patient acuity. It is descriptive and cannot show that HIV, ART, or aging caused the observed patterns.
Declared interests
No author conflict-of-interest declaration is given in the article text. The supplied publication types indicate research support from the National Institutes of Health and the U.S. Public Health Service.
The easy way to misread this
Do not read the 20.9% without ART as proof that nursing homes failed to provide HIV treatment. The study used prescription dispensing records, may not capture fills outside the provider, and some lack of ART may have matched guidelines at the time.