Strengths and Challenges of Various Models of Geriatric Consultation for Older Adults Living With Human Immunodeficiency Virus

Abstract As care of persons living with human immunodeficiency virus (HIV; PWH) has transitioned from management of opportunistic infections to management of conditions associated with older age, new models of geriatric consultation are needed. The authors, who represent 9 clinics across North America and the United Kingdom, provided their insights on models of geriatric consultation for older PWH. Three models of geriatric consultation are delineated: outpatient referral/consultation, combined HIV/geriatric multidisciplinary clinic, and dually trained providers within 1 clinical setting. A patient-centered approach and the use of expertise across disciplines were universally identified as strengths. Logistical barriers and the reluctance of older PWH to see a geriatric care provider were identified as barriers to implementing these models. Although the optimal model of geriatric consultation depends on a region’s resources, there is value in augmenting the training of infectious disease providers to include principles of geriatric care. For persons with human immunodeficiency virus (HIV) age 50 and over, there is an increasing need to address concerns associated with aging. Three models of geriatric consultation are described: outpatient referral/consultation, combined HIV/geriatric multidisciplinary clinic, and dually trained providers.