Symptom Disclosure by Older HIV-Infected Persons

The life expectancy for persons living with HIV infection is markedly increasing, largely because of the advances made with antiretroviral therapy. In comparison with other older individuals, those infected with HIV tend to have higher rates of liver-related conditions, diabetes, and dyslipidemia, as well as substance use and psychiatric disorders. Although these multimorbidities contribute to the symptom burden, older persons with HIV tend not to disclose symptoms to their health care providers. Culture, religion, age, and race can profoundly affect the way in which symptoms are perceived, and reasons for nondisclosure include attributing symptoms to the “normal” aging process. The purpose of this article is to highlight the unique situation of older patients with HIV regarding symptom disclosure and the need for an integrated treatment plan that includes an environment that promotes patient–provider communication, better day-to-day self-care, and self-management strategies.