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Cover of Strategies for Improving the Lives of Women Aged 40 and Above Living With HIV/AIDS

Strategies for Improving the Lives of Women Aged 40 and Above Living With HIV/AIDS

Technical Briefs, No. 29

Investigators: , MLIS, , MD, PhD, , MD, , BA, ScM, , MPH, CPH, and , MD.

Author Information and Affiliations
Rockville (MD): Agency for Healthcare Research and Quality (US); .
Report No.: 16(17)-EHC040-EF

Structured Abstract

Background:

While in its early years the HIV epidemic affected primarily the male and the young, nowadays the population living with HIV/AIDS comprises approximately 24 percent women, and its age composition has shifted towards older ages. Many women over 40 who live with HIV/AIDS also live with the medical and social conditions that accompany aging.

Objectives:

This work aims to identify and characterize empirical studies of strategies for the comprehensive management of women over 40, including transgender women, who live with HIV/AIDS.

Approach:

With input from a diverse panel of content experts and other stakeholders, we develop an evidence map to characterize empirical studies of strategies for improving the comprehensive care of older women who live with HIV/AIDS and apply to today's U.S. setting. We outline resources that are available to these women in a purposeful sample of six States (Rhode Island, Mississippi, Alabama, New York, California, Texas), and illustrate the importance of having integrated care using four vignettes.

Findings:

We identified 890 citations that address three areas of interest and enrolled women who live with HIV/AIDS. Of these, only 37 (4 percent) reported results of interest for older women, or examined interactions between gender and older age that would allow predictions in this subgroup. Few of the 37 eligible studies focused on women facing challenges, such as immigrants, transgender, physically abused, or those recently released from prison. No studies focused on women caring for dependents, those diagnosed after age 40 or those who have adequate health insurance. In the sample of States, we found more HIV resources (testing, housing, medical and mental health, and social support) in the large cities than others; in some median and small cities no HIV resources were found.

Interpretation:

The evidence base that is directly applicable to women over 40 who live with HIV/AIDS in the U.S. is limited. We make observations to inform the prioritization of future research.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services1, Contract No. 290-2015-00002-I. Prepared by: Brown Evidence-based Practice Center, Providence, Rhode Island

Suggested citation:

Adam GP, Di M, Cu-Uvin S, Halladay C, Smith BT, Trikalinos TA. Strategies for Improving the Lives of Women Aged 40 and Above Living With HIV/AIDS. Technical Brief No. 29. (Prepared by the Brown Evidence-based Practice Center under Contract No. 290-2015-00002-I.) AHRQ Publication No.16(17)-EHC040-EF . Rockville, MD: Agency for Healthcare Research and Quality; November 2016. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Brown Evidence-based Practice Center under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD HHSA 290-2015-00002-I. The findings and conclusions in this document are those of the authors who are responsible for its contents. The findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of the Agency for Healthcare Research and Quality or of the U.S. Department of Health and Human Services.

None of the investigators have any affiliations or financial involvement related to the material presented in this report.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies may not be stated or implied.

1

5600 Fishers Lane, Rockville, MD 20857; www​.ahrq.gov

Bookshelf ID: NBK401283PMID: 27929614

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