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Exploring the CORE Healthy Aging Initiative


Oluwatoyin (Toyin) Adeyemi, MD, attending physician of infectious diseases, at Cook County Health and Hospital System, discusses the CORE Healthy Aging Initiative (CHAI).
Interview Transcript (slightly modified for readability)
“Our research is called the CORE Healthy Aging Initiative and it’s because I work at the CORE center, which is an HIV and infectious disease clinic of the Cook County Health and Hospital System in Chicago. I’ve been practicing there since 2001, and really have been very interested in the aging [of] patients with HIV infections. Personally, about half of my patients in my practice are over the age of 50, and [although] 50 is kind of young, in the HIV world, it’s still what we call ‘aging’.
Nationally in the US, it’s thought [that] about anywhere between 45 to 50% of the adults living with HIV right now are over the age of 50, so [it’s] a large and growing population. Among new diagnoses of HIV, it’s thought to be somewhere between 17 to 20% of new infections are in adults over the age of 50. So, we have a mix of people who are newly diagnosed over the age of 50, and a large proportion of our patients who have been in care for decades who are aging well with HIV, but could be aging better.
There’s been a lot of press about aging with HIV, and the numbers, and lots of initiatives really looking at research questions, [such as] does HIV accelerate the process of aging? What are the comorbidities with HIV and aging? A lot of this has happened in research settings. What we really need to figure out is, what are the needs of the patients, [and] have the patients tell us what their concerns are. I think the best strategies that we develop come when they come from the patients themselves. Sometimes as researchers, as physicians, we think we know what needs to be done. While that’s great, we really need to make sure that we’re working with the patients.
There are organizations that have done a lot of work in trying to get the word out about advocacy for older adults [living with HIV]. I really do think there needs to be a lot more emphasis on primary care physicians and infectious disease physicians, like myself, approaching HIV as a comprehensive medical issue that has psychosocial and other implications.
The point of our research was really to figure out, in patients in our clinic at the CORE Center, where we see over 5,000 adults living with HIV (it’s the largest stand-alone HIV clinic in the Midwest), what their needs were for those older than 50 who are not enrolled in research studies. We have the WIHS studies and also we have MACS studies, we have the CEDAR [Project]– we have a lot of cohort studies. But, [we started] looking at patients who are not enrolled in clinical trials, who are coming in for doctor visits [or] nurse visits, and just asking what their needs are, [and engaging] that group that has not necessarily been engaged in research. The point of our study was to figure out what their needs were, to then develop strategies to address those needs both on a local level, and hopefully some of our findings translate nationally, because this is a national issue with half of [US individuals living with HIV are] older than 50.

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