1. 1 HIV and Aging: an Interprofessional Approach Le-Ann Dolan Program Director Canadian Working Group on HIV and Rehabilitation March 19, 2011

2. 2 Overview Background on HIV / CWGHR Integration into IP practice Lessons Learned Practical strategies for sustainability Next steps

3. 3 Canadian Working Group on HIV and Rehabilitation (CWGHR) National, multi-sector, multi-disciplinary organization Disability and rehab in context of HIV - Bridging HIV, disability & rehab Cross-disability and interprofessional Priorities - integrated approach - research, education, policy and practice Awareness of and access to rehab services and resources for people living with HIV and other episodic disabilities - cross disability/ pan disease collaboration IP learning / education - link to IP practice Promote effective policies to respond to needs Address the needs and concerns of families, caregivers, communities and people living with HIV-related disabilities

4. 4 Interprofessional Approach Bridge the traditionally separate HIV and Aging communities through a comprehensive interprofessional approach to: –Promote the understanding of the interaction among parallel and overlapping conditions –Stimulate the exchange of information about HIV and Aging care –Discover how the social determinants of health impact older people living with HIV –Assess sexual behaviour and HIV-related knowledge of all older Canadians

5. 5 Why Embark We see two emerging arenas of concern: 1) The impact of HAART and

6. 6 Paradigm shift from Terminal Disease to Chronic Illness Shift away from purely HIV-related morbidity/mortality Focus on prevention and treatment of Non-HIV causes of Morbidity & Mortality Focus on not just keeping people alive but providing a better quality of life / maintenance of health for the long run

7. 7 HIV as an Episodic Disability Marked by fluctuating periods and degrees of wellness and illness Unpredictable Other episodic disabilities include: some forms of mental illness, HIV/AIDS, multiple sclerosis, diabetes, arthritis, and some forms of cancer Presents challenges for active labour force participation, insurance benefits, income security, and social inclusion

8. 8 Background 2009 - CWGHR, funded by the Public Health Agency of Canada to develop a background paper on HIV and Aging 2010 – February – background paper completed and distributed Partners in Aging National Forum held in Montreal March 3-4, 2010

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10. 10 Final report developed (available at www.hivandrehab.ca) including 4 emerging themes for consideration in research, education, policy, and practice; www.hivandrehab.ca - Mental Health - Physical Health - Prevention - Social Determinants of Health

11. 11 Conclusion The prevalence of HIV among older adults in Canada is increasing Older adults are prone to a number of age- related comorbidities that complicate HIV management HIV treatment must be individualized to avoid exacerbating underlying conditions