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Why should we care about palliative care for AIDS in the era of antiretroviral therapy?
  1. P A Selwyn
  1. Correspondence to:
 Dr Peter A Selwyn
 Department of Family and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA;

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The possibility of pharmacological interactions between HIV medications and palliative care medications makes it essential to coordinate HIV specific and palliative care

Initially, in the now distant early years of the AIDS epidemic in the developed world, AIDS care was palliative care. As HIV/AIDS therapies have evolved rapidly since the mid-1990s, the focus of clinical care has increasingly been on antiretroviral therapy and the complex decision making that surrounds its use. While the growing “medicalisation” of AIDS is in part because of the advent of effective treatment with the possibility of controlling viral replication and disease progression, the emergence of this more biomedical paradigm has resulted in a loss of perspective on chronic disease and the issues relevant to progressive, incurable illness and end of life care. Early in the epidemic, HIV care providers were by definition palliative care providers. Now the challenge is to reacquaint what have since developed into two distinct disciplines, in order to provide our patients with the benefits of both types of expertise.

As outlined in the review article by Harding et al in this issue of STI (p 5), it is important for HIV care providers to remain sensitive to the need for palliative care interventions across the continuum of HIV disease. Palliative medicine has much …

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