Causes of Death in HIV Patients and the Evolution of an AIDS Hospice: 1988–2008

• Main Authors: Ann Stewart, Soo Chan Carusone, Kent To, Nicole Schaefer-McDaniel, Mark Halman, Richard Grimes
• Format: Article
• Language: English
• Published: Hindawi Limited 2012-01-01
• Series: AIDS Research and Treatment
• Online Access: http://dx.doi.org/10.1155/2012/390406

This paper reports on the transformation that has occurred in the care of people living with HIV/AIDS in a Toronto Hospice. Casey House opened in the pre-HAART era to care exclusively for people with HIV/AIDS, an incurable disease. At the time, all patients were admitted for palliative care and all deaths were due to AIDS-defining conditions. AIDS-defining malignancies accounted for 22 percent of deaths, mainly, Kaposi sarcoma and lymphoma. In the post-HAART era, AIDS-defining malignancies dropped dramatically and non-AIDS-defining malignancies became a significant cause of death, including liver cancer, lung cancer and gastric cancers. In the post-HAART era, people living with HIV/AIDS served at Casey House have changed considerably, with increasing numbers of patients facing homelessness and mental health issues, including substance use. Casey House offers a picture of the evolving epidemic and provides insight into changes and improvements made in the care of these patients.