Nursing home admission of aging HIV patients: Challenges and obstacles for medical and nursing staffs

ObjectivesHIV infection became a chronic illness. People can live with it for many years, with multiple comorbid conditions, frailty syndrome, and polypharmacy. Infected persons may require admission to a nursing home (NH) younger than geriatric patients because of their underlying medical and social status.MethodWe decided to conduct a survey in 53 randomly selected NHs in three French departments. The main issue was to understand the challenges and obstacles regarding admission to a NH.ResultsOverall, 49 physician questionnaires and 201 staff questionnaires were collected from 53 NHs. Only four physicians (8.2%) had already admitted HIV residents to their NH. More than three-quarters of staff agreed to admit HIV patients without restriction (67.2%) or with restrictions (13.4%). The lack of formal teaching/training and the staff/resident concerns about contamination were the two main reasons to refuse infected patients entry. Almost one out of three physicians (28.6%) and two-thirds (64.2%) of staff members indicated that HIV education was necessary.ConclusionOur study shows that nearly one-third of the NHs staff has reservations about the admission of HIV-positive patients. Nowadays healthcare workers in geriatric care are unaware of the latest developments regarding HIV, not only the medical but also the social aspects, and the consequences for the HIV-infected patient. We therefore must turn our efforts to staff training, particularly on the mode of transmission of the virus and the positive impact of treatment in decreasing the risk of HIV transmission to improve NH access to HIV-positive patients.