Grant: DRA : Canada Graduate Research Scholarship - Doctoral Program (CGRS D)

Everyone dies, but the paths people take towards death differ and influence quality of care, the well-being of caregivers, and the demands placed on healthcare systems. In Canada, where the population is aging, there is a growing need to understand this end-of-life period in order to provide quality, patient-centred care. Much research has focused on conditions such as cancer, but little is known about how people living with HIV (PLWH) experience the end of life. In British Columbia (BC), more than half of PLWH are now over the age of 50. Many are aging with the legacy of complications related to HIV while also carrying a higher burden of non-HIV illnesses such as cardiovascular disease, cancer, and frailty. These medical challenges are compounded by social factors, including stigma, poverty, and isolation, which can further complicate care. This combination creates unique end-of-life pathways that remain poorly understood. My research aims to illuminate these pathways by identifying the medical and social factors that shape the final years of life for PLWH. Working at the BC Centre for Excellence in HIV/AIDS, I will use its comprehensive clinical data repository, which has tracked HIV and non-HIV care in BC since 1992. Through advanced statistical modeling, I will compare PLWH with people who are not living with HIV to examine patterns of healthcare use, identify disparities in access and outcomes, and assess how frailty develops near the end of life. This study will also prioritize inclusive knowledge translation. Partnering with BC-based HIV organizations, I will share findings through policy briefs, fact sheets, and peer-reviewed publications. The results will directly inform the BC HIV Therapeutic Guidelines Committee, helping to develop tailored, evidence-based strategies that address both the medical and social needs of PLWH. Ultimately, this research will improve end-of-life care for PLWH in BC and set a foundation for policy and practice across Canada.