Advance Directives and HIV: A Current Trend in the Inner City; Journal of Community Health; Pascal J. de Caprariis, Alex Carballo-Dieguez, Sarah Thompson, and Claudia Lyon (2012)

This exploratory study examines the prevalence and trends of advance directives among people with HIV hospitalized in an inner city community hospital. An advance directive (AD), such as a living will or power of attorney, specifies an individual’s health decisions for circumstances in which they are too ill to express their wishes or are otherwise incapacitated. With the onset of the HIV epidemic decades ago, the need for ADs dramatically increased, and the high number of hospitalized patients with HIV without an AD required attention. As medical treatment capabilities improved and hospital admission and mortality rates decreased, ADs remain an important part of comprehensive medical care.

This retrospective study operates within this evolving medical context and analyzes AD orders for hospitalized patients with HIV from 2004 to 2011, noting whether the AD was made prior to or during hospital admission. The study’s major findings include: no statistical difference in predominance of ADs from a private practice or clinical setting, no increase in ADs with increasing age, and no increase in ADs with longer years with an HIV diagnosis. Reasons for such results are speculative in nature. However, AD rates were extremely low, identifying the need for more research to adequately address the AD needs of this population.