Although health systems in most low-income countries largely provide episodic care for acute symptomatic conditions, many HIV programs have developed effective, locally owned and contextually appropriate policies, systems and tools to support chronic care services for persons living with HIV (PLWH). The continuity of care provided by such programs may be especially critical for older PLWH, who are at risk for more rapid progression of disease and are more likely to have complications of HIV and its treatment than their younger counterparts. Older PLWH are also more likely to have other chronic noncommunicable diseases (NCDs), including hypertension, diabetes, cancers and chronic lung disease. As the number of older PLWH rises, enhanced chronic care systems will be required to optimize their health and wellbeing. These systems, lessons and resources can also be leveraged to support the burgeoning numbers of HIV-negative individuals with chronic NCD in need of ongoing care.
bDepartment of Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York, USA.
Correspondence to Miriam Rabkin, MD, MPH, Associate Clinical Professor of Medicine and Epidemiology, Director for Health Systems Strategies, ICAP Columbia, Columbia University Mailman School of Public Health, 722 West 168th Street, 13th Floor, New York, NY 10032, USA. E-mail: email@example.com
Received 12 December, 2011
Accepted 6 April, 2012