Preference for care models among older people living with HIV: cross-sectional study

The number of people living with HIV (PWH) aged 50 and above is increasing. The question of care among older PWH (aged ≥ 50 years) is an increasing concern. Understanding the care preference of older people can better provide care services for them. The purpose of this study was to investigate the care preference (home-based care, self-care, institutional care, community-based care, and mutual-aid care) among older PWH and identify the factors affecting their care preference.

A cross-sectional survey was conducted among older PWH (aged ≥ 50 years) about care preference from May to November 2021. We enrolled 319 participants using convenience sampling. We designed a questionnaire to assess the care preference of older PWH. The Chi-square test and Fisher's exact test were used to conduct univariate analysis of care preference. Multinomial logistic regression was used to identify factors influencing care preference.

Most older PWH (72.7%) preferred home-based care, and few (15.7%) preferred self-care. Fewer older PWH preferred community-based care (5.3%), institutional care (5.0%) and mutual-aid care (1.3%). Multivariate analysis showed that older PWH with a house, spouse and more children were more inclined to choose home-based care (p < .05). Older PWH living alone, having higher monthly income and higher HIV stigma preferred to choose self-care (p < .05).

Home-based care was the most preferred model of older PWH, and self-care ranked second. The number of those who preferred institutional care, community-based care and mutual-aid care were few. Nation and government should take measures to allocate care resources for older adults reasonably to better meet the care needs of older PWH. It is important to strengthen social security, reduce internalized HIV stigma, improve social support, and explore diversified care models for improving the quality of life of older PWH.