Systematic Review: HIV, Aging, and Housing-A North American Perspective, 2012-2023.

Area of Science:

• Geriatric Medicine
• Public Health
• Social Sciences

Background:

• Anti-retroviral therapy (ART) has increased lifespan for people with HIV, creating a growing population of older adults (50+) living with the virus.
• The unique housing experiences and unmet needs of this demographic remain under-researched, hindering comprehensive care.
• Understanding these challenges is vital for developing targeted support services for aging individuals with HIV.

Purpose of the Study:

• To systematically review and analyze the literature on housing access, insecurity, assistance, and impact for older adults with HIV in North America (2012-2023).
• To identify emerging public health themes and understand term relationships within the literature using Latent Semantic Analysis (LSA) and Singular Value Decomposition (SVD).
• To inform the development of better healthcare and social support policies for this population.

Main Methods:

• Systematic literature review of peer-reviewed articles from 2012 to 2023 focusing on housing and older adults with HIV.
• Application of Latent Semantic Analysis (LSA) for text-mining unstructured abstract data.
• Utilized Singular Value Decomposition (SVD) for text clustering to identify key themes and relationships.

Main Results:

• Text clustering identified two primary areas: (1) improvements in housing and healthcare access/policy, and (2) unmet needs including social support, mental health, financial, food, and sexual insecurities.
• Topic modeling revealed four key themes: holistic care approach, basic needs insecurities (food, finance, sexuality), access to housing and healthcare, and the link between homelessness and HIV health outcomes.
• Stable housing, food security, and healthcare access are critical for holistic care of older adults with HIV.

Conclusions:

• A holistic, patient-centered approach is essential for geriatric HIV care, addressing individual barriers and ensuring long-term follow-up.
• Policy changes are urgently needed to ensure accessible and equitable healthcare and housing for the aging HIV population.
• Integrating social support, mental health services, and addressing financial and food insecurities are critical components of comprehensive care models for older adults with HIV.