Associate Professor of Medicine (Infectious Diseases); Director, Yale Center for Infectious Diseases, Infectious Diseases; Program Director, HIV Primary Care Training Track, Internal Medicine; Project Director, Connecticut New England AIDS Education & Training Center, HRSA
Yale HIV and Aging Program
Yale Infectious Diseases’ 4Fs Program
More than half of people living with HIV in the US are 50 years or older, and it is estimated that almost 25% will be 65+ years of age by 2030. At the Yale Center for Infectious Diseases, 2/3 of patients living with HIV are older than 50 years and almost 1/3 are older than 65 years.
Many patients cared for at our Center have two or more co-morbid conditions and are prescribed more than five medications. Fifty percent of men in our cohort report a fall in the past year. While not all these falls have resulted in a visit to a healthcare provider, it is well established that falls are a key cause of fragility fractures and hospitalization among older adults.
While HIV providers have expertise in providing outstanding care, they may lack the expertise in screening for and managing geriatric conditions such as polypharmacy, falls, and fragility fractures. Yale Infectious Diseases’ 4Fs program seeks to help HIV providers improve the care they give to older adults living with HIV.
Unique Collaborative Care Model
Dr. Michael Virata with patient
Our 4F intervention is a collaborative care model designed to train HIV providers at Yale to assess and prevent conditions associated with aging in their patients aging with HIV. The model involves training a cadre of HIV champion providers to integrate screening and preventing risks related to polypharmacy, falls, fragility and fractures (the 4Fs) as part of an annual wellness visit for their patients who are 50+ years old, and to develop appropriate care plans to address these risks as part of an interdisciplinary care team approach.
Program Goals
The Yale HIV and Aging Program team consult with a patient.
- To build the capacity of HIV providers in geriatric care with a focus on the 4Fs
- To develop toolkits to help patients and providers screen for and prevent the 4Fs
- To improve the quality of life of patients aging with HIV and decrease health disparities
Primary Care Team
Associate Professor Term; Director, HIV Clinical Services, Internal Medicine; Associate Professor of Clinical Internal Medicine, Yale Medicine; Program Director, Medicine, HIV Care and Prevention Program, Yale-New Haven Hospital