Access and equity in HIV/AIDS palliative care: a review of the evidence and responses.

Abstract:

:The high prevalence of pain and other symptoms throughout the HIV disease trajectory, the need for management of side effects related to antiretroviral therapy, the continuing incidence of cancers and new emerging co-morbidities as a result of extended life expectancy under new therapeutic regimes, and the ongoing need for terminal care all prove the curative versus palliative dichotomy to be inappropriate. Although there is evidence for both need and effectiveness of palliative care in HIV patient care, access is often poor and care less than optimal. This review aimed to identify evidence of barriers and inequalities in HIV palliative care in order to inform policy and service development. Biomedical databases were searched using a specific strategy, and evidence extracted into the barrier and inequity categories of patient, clinician, service and disease factors. A model of the barriers and inequalities is presented from the evidence. Recommendations are made from the evidence for promoting access and outcomes through integrated palliative care from diagnosis to end-of-life, alongside antiretroviral therapy when initiated. Service responses that have attempted to increase access to palliative care are presented.

journal_name

Palliat Med

journal_title

Palliative medicine

authors

Harding R,Easterbrook P,Higginson IJ,Karus D,Raveis VH,Marconi K

doi

10.1191/0269216305pm1005oa

subject

Has Abstract

pub_date

2005-04-01 00:00:00

pages

251-8

issue

3

eissn

0269-2163

issn

1477-030X

journal_volume

19

pub_type

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