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participating institutions:
Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital



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End-of-Life Discussions and Preferences Among Persons With HIV [Wenger NS et al. JAMA 2001; 285: 2880]: This report is from HCSUS, a cross-sectional survey of the U.S. representing 231,400 patients receiving HIV care. The present study concerned a sample of 2,864 patients who were interviewed from 1996-97. Of these, 1,432 (50%) had discussed some aspect of end-of-life care with their care provider, and 1,088 (38%) had completed an advanced directive. In terms of preferences, the number willing to live permanently in coma was 5-18%, in pain was 11-52%, attached to a ventilator (6-24%), tube feeding 15-32% and confused 44-68%. In general, the latter number refers to those who would accept this state if it would definitely extend life.
Comment: The authors lament the fact that studies in the late 1980's and the early 1990's showed about the same results in terms of frequency of discussions regarding end-of-life issues with AIDS patients [NEJM 1986; 314: 457]. The dearth of such discussions was significantly greater among African-Americans, Latinos, injection drug users, and poorly educated patients.
posted 6/22/2001





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