Sharing the burden: The experiences of HIV psychiatrists delivering primary palliative care.

TitleSharing the burden: The experiences of HIV psychiatrists delivering primary palliative care.
Publication TypeJournal Article
Year of Publication2025
AuthorsBhatia S, Ekwebelem MI, Nims C, Riffin C, M Reid C, Shalev D
JournalPalliat Support Care
Volume23
Paginatione73
Date Published2025 Mar 07
ISSN1478-9523
KeywordsAdult, Female, HIV Infections, Humans, Interviews as Topic, Male, Middle Aged, Palliative Care, Primary Health Care, Psychiatrists, Psychiatry, Qualitative Research
Abstract

OBJECTIVES: People living with HIV experience an elevated risk of serious medical illnesses as they age, but access palliative care (PC) at lower rates than individuals without HIV. HIV psychiatrists provide longitudinal psychosocial care to individuals living with HIV. As such, HIV psychiatrists can play an important role in providing PC to people living with HIV (PLWH). This qualitative study was conducted to explore the perspectives and experiences of HIV psychiatrists in addressing the PC of PLWH.

METHODS: We conducted semi-structured interviews with HIV psychiatrists. Data were analyzed using thematic analysis.

RESULTS: Nineteen HIV psychiatrists were interviewed. Three core themes with several subthemes were identified. These were: (1) lack of an operationalized role for HIV psychiatrists in supporting PC provision, (2) heterogeneity in engagement with PC among HIV psychiatrists, and (3) HIV psychiatrists have valuable skills to address patients' PC needs but also face unique challenges in doing so.

SIGNIFICANCE OF RESULTS: Overall, we found that there is significant heterogeneity in how HIV psychiatrists provide PC. Psychiatrists were interested in engagement with PC but felt their roles and scope were poorly defined. This study points to the possibility for greater integration of HIV psychiatrists in the provision of PC for patients with HIV through improvements in PC training for psychiatrists who work with patients with medical illness and through a more operationalized role and scope of practice in this domain of care.

DOI10.1017/S1478951525000124
Alternate JournalPalliat Support Care
PubMed ID40051231
PubMed Central IDPMC11893077
Grant ListK24 AG053462 / AG / NIA NIH HHS / United States
K76 AG083287 / AG / NIA NIH HHS / United States