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AFLE-HIV: developing an age-friendly living environment assessment framework for elderly HIV-infected individuals in
Quan Wen1,2, Mazran Ismail3, Muhammad Hafeez Abdul Nasir4
1School of Art and Design, Henan Industry and Trade Vocational College, Zhengzhou, Henan, 451191, China. wenquan@hngm.edu.cn.
BMC Public Health
|June 3, 2026
Summary
A new assessment framework, AFLE-HIV, helps evaluate residential settings for older adults with HIV. This tool aids in identifying environmental needs for improved care and age-friendly living.
Area of Science:
- Gerontology
- Public Health
- HIV Medicine
Background:
- Growing population of older adults living with HIV in China.
- Lack of validated instruments to assess residential environments for this demographic.
- Need for tools to address the dual demands of aging and HIV management in housing.
Purpose of the Study:
- To develop and validate the Age-Friendly Living Environment for Elderly HIV-Infected Individuals (AFLE-HIV) assessment framework.
- To create a structured protocol for evaluating residential settings for older adults with HIV.
- To provide an evidence-based tool for improving housing conditions and care delivery.
Main Methods:
- Sequential mixed-methods design utilizing Latent Dirichlet Allocation on 347 publications.
- Two rounds of Delphi consultation with 22 multidisciplinary experts.
- Analytic Hierarchy Process for weight calibration and a pilot test in 12 residential communities.
Main Results:
- Consolidated framework with three dimensions and 13 validated indicators.
- Statistically significant inter-expert agreement and satisfactory content validity.
- Satisfactory scale reliability and moderate inter-rater concordance in pilot testing.
Conclusions:
- The AFLE-HIV instrument provides a structured protocol for diagnosing environmental shortcomings in residential settings.
- Offers policymakers evidence for renovation investments aligned with the HIV care continuum.
- Provides urban planners with benchmarks for age-friendly residential upgrades for this population.
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