Advancing integration in the approach to older adults with HIV: perspectives from geriatric and HIV specialists

Background: The aging of people with HIV (PWH) is a growing public health concern, with projections indicating that by 2030, up to 70% of this population will be aged 50 years or older. Despite the increasing prevalence of age-related comorbidities and geriatric syndromes in older adults with HIV (OAWH), the integration of geriatric expertise into HIV care remains limited. This study aimed to assess geriatricians’ knowledge and involvement in the care of OAWH and to explore HIV specialists’ attitudes toward collaborative, multidisciplinary care. Methods: A cross-sectional, descriptive study was conducted using two structured online surveys—one for geriatricians and one for HIV specialists—disseminated through national scientific societies in Spain, Italy, Mexico, and Canada. The surveys assessed clinical experience, knowledge, and attitudes toward OAWH care, and were developed by experts with over 15 years of clinical experience. Data were collected anonymously via the REDCap platform and analyzed descriptively. Results: A total of 348 responses were received: 200 from geriatricians and 148 from HIV specialists. Among geriatricians, 42% correctly identified the age threshold for OAWH, and 73% reported seeing one or no OAWH in the previous year. Furthermore, 92.5% indicated a need for further training. HIV specialists largely recognized the importance of adapting care for OAWH, with 91.2% acknowledging frailty as clinically relevant. However, only 38% routinely performed frailty screening. Both groups expressed support for increased collaboration, though only around half believed that geriatricians should be systematically involved in OAWH care. Conclusions: This study highlights significant gaps in knowledge, training, and interdisciplinary collaboration in the care of OAWH. While both geriatricians and HIV specialists recognize the unique needs of this population, barriers such as insufficient training and role ambiguity hinder progress. Our findings support earlier, biologically informed interventions and integration of geriatrics into routine HIV care; targeted training and institutional support appear warranted.