title: End-of-life care for HIV-infected patients with malignancies: A questionnaire-based survey.
abstract: The number of HIV-infected patients who require palliative or end-of-life care is increasing, and the status of end-of-life care for HIV patients with malignancies is unclear.
  
  
  
  This study aimed to evaluate the end-of-life care provided to HIV patients with malignancies in Japan.
  
  
  
  National cross-sectional questionnaire-based survey.
  
  
  
  Questionnaires were delivered to the medical staff of 378 regional core hospitals/core hospitals for AIDS and 285 palliative care units in Japan. Data were collected between August and October 2013.
  
  
  
  Overall, 226 regional core hospitals/core hospitals for AIDS (59.8%) responded. A total of 55 institutions (24.3%) provided end-of-life care to HIV patients with malignancies. Regarding the place of death of the patients, 69.1% died at the institution whereas 18.2% were transferred to palliative care units. The requests of 16 (29.1%) institutions to transfer patients to palliative care units were rejected. Of the 378 palliative care units, 179 (62.8%) responded. While 13 palliative care units (4.6%) provided care to hospitalized HIV patients with malignancies, 20 (11.2%) refused to accept these patients for treatment because of a lack of experience in treating these patients and a lack of knowledge regarding HIV infection.
  
  
  
  Our findings suggest that in Japan, HIV patients with malignancies have difficulties obtaining hospitalization at a palliative care unit, which is likely due to a lack of experience among the professionals in treating such patients as well as a lack of knowledge about HIV.
authors.affiliation: Department of Hematology and Oncology, Nagoya University Graduate school of Medicine, Nagoya, Japan Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kojima
authors.affiliation: Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: Nami
authors.initials: N
authors.lastname: Iwasaki
authors.affiliation: Center for Infectious Disease and Infection Control, Keio University, Tokyo, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Yanaga
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Tanuma
authors.affiliation: Department of Hematology, Shiga University of Medical Science Hospital, Shiga, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Koizumi
authors.affiliation: Department of Infectious Diseases, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Uehira
authors.affiliation: Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan.
authors.forename: Mihoko
authors.initials: M
authors.lastname: Yotsumoto
authors.affiliation: Department of Infectious Disease, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ajisawa
authors.affiliation: Department of Hematology, Internal Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Hagiwara
authors.affiliation: Center for AIDS Research, Kumamoto University, Kumamoto, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Okada
authors.affiliation: Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan nagaih@nnh.hosp.go.jp.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nagai
mesh_terms: D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007564:Japan; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care; D011795:Surveys and Questionnaires; D013727:Terminal Care
keywords: AIDS; HIV; Palliative care; hospice; neoplasms; terminal care