Mount Sinai Geriatricians to Develop Model Health Care Program for Older Adults With HIV
Grants will fund expansion of interdisciplinary care model and development of curriculum and demonstration program for other hospitals
A team of geriatricians at Mount Sinai’s Brookdale Department of Geriatrics and Palliative Medicine has been awarded $1.25 million from the Health Resources and Services Administration and the Keith Haring Foundation to expand Mount Sinai’s interdisciplinary model of care for older patients living with HIV. The awards will support the development of a curriculum and demonstration program that other hospitals and health systems can adopt.
With the development of effective treatments for HIV, deaths from AIDS and opportunistic infections have significantly decreased, so many more people are living with HIV past the age of 50. “Looking back to the very dark years of the 1980s, when we lost so many patients to HIV/AIDS, it is really remarkable that we are now treating so many adults who have been living with HIV for so long,” says Principal Investigator Nathan Goldstein, MD, Professor of Geriatrics and Palliative Medicine, and Medicine, at the Icahn School of Medicine at Mount Sinai. “This is thanks in large part to the development of safe and effective antiretroviral medications that have kept many patients with HIV alive well into their 50s, and indeed, old age.”
Nevertheless, the aging of this patient population presents new challenges for health care providers. These older adults face the complications of HIV and its treatments along with the diseases and conditions of “normal” aging, including changes in body chemistry and functioning, says Dr. Goldstein.
“We are enormously grateful to the Health Resources and Services Administration and the Keith Haring Foundation for their support, which will greatly help us meet the unique physical, social, and psychological needs of this population,” says Dr. Goldstein. “These issues were present before the COVID-19 pandemic, but now we are seeing that issues such as social isolation and not going to the doctor for two years have created a snowball effect that has only increased the needs of this unique and vulnerable patient population.”
The Peter Krueger Clinic at Mount Sinai Beth Israel, formed in 1989 during the height of the HIV/AIDS epidemic, has served as the central home for Mount Sinai Beth Israel’s compassionate and comprehensive HIV care. The clinic is one of the country’s leading health care providers for people with HIV/AIDS. Over the years, it has served as a clinical trial site that has helped develop the very therapies that have extended the lives, and good health, of aging HIV patients.
The clinic is part of the larger Institute for Advanced Medicine at Mount Sinai (IAM), which specializes in the treatment of groups who are underserved or have specialized needs, no matter one’s background, ethnicity, or sexual orientation, including patients with HIV/AIDS, LGBTQ+ people, victims of domestic violence, and recently incarcerated men and women who are transitioning to life on their own. The IAM has distinguished itself as a leader in medical prevention, treatment, and clinical education, in addition to community outreach services.
“Over the past two years, we have developed a collaborative, interdisciplinary pilot program of care for older patients with HIV, and with these grants we will further improve upon this model. The foundation of the program hinges on a team approach that involves a practice-within-a-practice model with a geriatrician, a social worker, a nurse, and a pharmacist, all under one roof,” says clinical lead Angela Condo, MD, Assistant Professor of Geriatrics and Palliative Medicine at Icahn Mount Sinai.
“To this team, we will add a community health worker who will support patients as they navigate the health care system, including helping them understand the importance of seeing all of their doctors and making sure they have the ability to get to those visits. For example, the community health worker not only explains the importance of going to see a certain specialist but also explores whether or not a patient needs help with transportation to even get to the appointment,” says Dr. Condo.
The geriatricians will also create a curriculum to help disseminate the program to other hospitals and health systems. “In this way, we can help other centers by equipping them with curricula and learning modules that can be easily disseminated and readily adopted by centers that do not have the luxury of several years to train their clinical teams in the complexities of caring for this unique population,” says Dr. Goldstein.
The Mount Sinai Hospital is ranked No. 1 in the country for Geriatrics by U.S. News & World Report.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: It is consistently ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and top 20 in the nation for National Institutes of Health funding and top 5 in the nation for numerous basic and clinical research areas. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.