Recent advances in human immunodeficiency virus (HIV) therapy have significantly
reduced HIV-related mortality in the developed world, but mortality rates
have plateaued, and AIDS remains a leading cause of serious illness and death
for young adults. The chronic nature of the HIV disease course and the increasing
burden of cumulative HIV-related morbidity and treatment-related toxic effects
pose new challenges to the care of patients over time. Uncertainties about
prognosis and the promise and limitations of rapidly evolving therapies have
made decision making about advance care planning and end-of-life issues more
complex and elusive than when the disease course was more uniform, rapid,
and predictable. The emerging biomedical paradigm of highly active antiretroviral
therapy (HAART) as the cornerstone of treatment has helped to transform HIV
into a manageable chronic disease, yet at the same time has resulted in a
more narrow focus and a de facto separation between disease-specific "curative"
and symptom-specific "palliative" care for patients with HIV/AIDS. As patients
survive longer in the latter stages of progressive HIV disease, they may in
fact have increasing need for comprehensive symptom management as well as
wide-ranging need for psychosocial, family, and care planning support. In
the HAART era, the false dichotomy of curative vs palliative care for patients
with HIV/AIDS must be supplanted by a more integrated model to provide comprehensive
care for patients with advanced HIV disease and their families.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 33
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Users' Guides to the Medical Literature
For example, a trial of intravenous immunoglobulin in advanced human immunodeficiency infection...
The Rational Clinical Examination
Evidence Summary and Review 3
All results at
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.