Medical, Social and Supportive Services for Older Adults with HIV.

Older people living with HIV are increasingly requiring formal supportive community-based services. Supportive services are essential to medical care and treatment for older people living with HIV/AIDS. This chapter considers Andersen's behavioral model of health services, and explores the predisposing, enabling, and need factors that affect service utilization among the older HIV population. The Andersen model provides a lens to understand the need for supportive services to go beyond primary medical care. Examples of such services and referrals typically include medical and non-medical case management, clinical provider referrals, mental health and substance use treatment, housing assistance, legal services, nutrition, transportation, home care, emergency assistance, patient education support groups, and other programs such as the AIDS Drug Assistance Program and secondary prevention services. Barriers to assistance and support, and consequences and resources for caregivers are addressed. Aspects surrounding structural inequities, multiple-minority status, and HIV stigma are examined with the goal of offering insight and advocacy ideas for community-based providers and policy makers. In future, the healthcare and supportive services infrastructure must be better equipped to manage the distinctive treatment and care needs of HIV-positive older adults.