Chronic pain, functional status, and life satisfaction are associated with patients living with HIV discussing advanced care planning with their family or friends.

CONTEXT: In the era of effective antiretroviral therapy, persons living with HIV/AIDS (PLWHA) are living longer, transforming HIV into a serious chronic illness, warranting discussions between patients and their loved ones about advanced care planning (ACP). Evidence is needed on factors associated with patients' likelihood to discuss ACP with loved ones.

OBJECTIVES: To further characterize factors associated with successful ACP in PLWHA with their loved ones, we examined associations between patients having ACP discussions with the need for assistance with personal care, chronic pain, life satisfaction, prior family disagreements over healthcare decisions, sex, age, and interference in daily routines due to memory problems.

METHODS: Data were from the Affirm Care study (N=370), which examined social and environmental factors associated with health outcomes among PLWHA and their informal caregivers.

RESULTS: Slightly more than half of respondents discussed ACP with loved ones (57%). In adjusted analysis, higher levels of chronic pain (odds ratio (OR) =2.09, p=0.045), needing assistance with personal care (OR=1.63, p=0.023), greater life satisfaction (OR 1.02, p=0.002), prior family arguments over healthcare decisions (OR=2.80, p<0.001) and female sex (OR 2.22, p=0.001) were associated with higher odds of discussing ACP with loved ones, while age, drug use, education level, depression, and memory problems were non-significant.

CONCLUSION: These results suggest that interventions to increase ACP among PLWHA and their loved ones should target males. The findings also suggest PLWHA with chronic pain, the need for assistance with personal care, and those with a history of prior family arguments over healthcare decisions may be primed for ACP.