Care & Treatment: HIV as a Chronic Condition

This article was written by AIDS Calgary’s Support Services Team Lead


There have been many developments in HIV/AIDS over the last 30 years. The changes have made us reframe and rethink the way we see and understand HIV. In a very short time, receiving an HIV diagnosis has been altered from a death sentence to a chronic condition. At the International AIDS Conference in Washington DC in July 2012, there was an interesting session on what it means to see HIV through the lens of a chronic condition. A clear message was delivered that both HIV and other non-communicable diseases (NCD) that are chronic conditions can learn a lot from each other and can they can influence the way care and treatment is provided.

First, there are similarities between HIV and NCD that need to be understood. NCD such as diabetes and heart disease are massive issues in society both by the number of people impacted and the impact they have on financial, social and medical systems. Both, as well, have a long term impact on people’s lives. HIV & NCD are episodic which means people affected can experience periods of illness and periods of wellness throughout their lifetimes. Both, however, involve a high loss of life at a younger age. They also have a similar impact on persons’ lives involving multiple layers of medical care, appointments, medical regime and influence major life areas such as employment, social and mental health. Lower & middle income populations are over represented in both HIV and NCD.

HIV, of course, is also unique. There are differences between HIV and NCD that influence the care and treatment of HIV. In good news, HIV has a falling mortality rate unlike some NCD. On the other side, HIV carries a stigma like no other illness. There are also different key populations that are at an increased rate of HIV such as people who use drugs, men who have sex with men and sex workers who unique needs need to be addressed when looking at care and treatment.

Keeping the similarities and differences in mind, HIV can and has taught us a lot about care and treatment of chronic conditions. HIV/AIDS has been a pathfinder in navigating chronic health care. When looking at the rapid changes in HIV treatment, UNAIDS reports that HIV has become the first illness to provide support for chronic care in multiple and diverse settings. HIV care has also been multifaceted in its approach-medical assistance, social support, education, awareness and advocacy have all played a big role in care and treatment. As well, one of the most unique aspects of HIV is that the voices of those affected have been prominent as people living with HIV (PHA) have driven the development of prevention, support and care of HIV.

What does this all mean? When addressing chronic illnesses, we know that we need to have simplified, affordable and accessible treatment and care for all those living with the condition. Those living with chronic conditions also need support across the lifespan that adapts and changes to a variety of needs throughout the lifecycle. Addressing chronic conditions also means offering support and care to those affected - the family, friends, employers and caregivers, as examples, of people living with a chronic condition. Challenges, of course, of lumping HIV with other chronic illness is that we don’t address the uniqueness needs of those living with HIV, such stigma or the uniqueness needs of the key populations affected.

For more information
AIDS 2012 Care and Treatment for People with Chronic Conditions: What Can We Learn from the HIV Experience? A Health Systems Perspective abstract http://pag.aids2012.org/session.aspx?s=111

noncommunicable diseases
UNAIDS Report: Chronic care of HIV and non-communicable disease shttp://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/20110526_JC2145_Chronic_care_of_HIV.pdf