Have You Talked about It: Advance Care Planning among African Americans Living with HIV in Baltimore

Advance care planning (ACP) is the process of planning for when individuals are unable to make their own healthcare decisions. Research suggests ACP is understudied among HIV-positive African Americans. We explored ACP knowledge, preferences, and practices with HIV-positive African Americans from an...

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Bibliographic Details
Published in:Journal of urban health 2017-10, Vol.94 (5), p.730-745
Main Authors: Maragh-Bass, Allysha C., Zhao, Yiqing, Isenberg, Sarina R., Mitchell, Mary M., Knowlton, Amy R.
Format: Article
Language:English
Subjects:
Adaptation, Psychological
Advance Care Planning
Advance directives
African Americans
African Americans - psychology
Aged
Baltimore - epidemiology
Caregivers - psychology
Decision making
Decisions
Epidemiology
Female
Health care
Health Informatics
Health Knowledge, Attitudes, Practice
HIV
HIV Infections - ethnology
Human immunodeficiency virus
Humans
Interviews as Topic
Male
Medicine
Medicine & Public Health
Middle Aged
Minority & ethnic groups
Mixed methods research
Pain
Pain Management - psychology
Polls & surveys
Public Health
Qualitative analysis
Qualitative Research
Quality of Life
Regression analysis
Sex Factors
Social Support
Socioeconomic Factors
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Summary:Advance care planning (ACP) is the process of planning for when individuals are unable to make their own healthcare decisions. Research suggests ACP is understudied among HIV-positive African Americans. We explored ACP knowledge, preferences, and practices with HIV-positive African Americans from an urban HIV-specialty clinic (AFFIRM study). Participants completed surveys and interviews. Descriptive analyses and Poisson regression were conducted on survey data. Qualitative interviews were coded using grounded theory/constant comparative method. Participants were mostly male (55.1%). Half rated their current pain as at least six out of ten (50.8%). Two-thirds had discussed ACP with providers or supporters (66.2%). Qualitative themes were: (1) impact of managing pain on quality of life and healthcare, (2) knowledge/preferences for ACP, and (3) sources of HIV supportive care and coping ( N  = 39). Correlates of having discussed ACP included: moderate pain intensity ( p  
ISSN:1099-3460
1468-2869
DOI:10.1007/s11524-017-0157-y