Recent literature has continued to highlight the growing challenge that frailty could pose to people living with HIV, and the services they access, if not adequately managed.^{2,20,31,42–43} But it’s also highlighted an important unmet need in our ability to respond effectively as a result of limitations with current tools and the lack of consensus or guidelines around how to define, identify, assess and manage frailty in this setting.^44–45

In the absence of formal guidance or a consensus definition of frailty, Gilead Sciences Ltd wanted to equip healthcare practitioners with the skills, knowledge and confidence they need to identify those who are experiencing or at risk of frailty earlier and manage them effectively so as to help promote successful ageing.  

Six senior healthcare professionals with expertise across different disciplines of HIV care were therefore contracted to support the co-creation of this practical guide. Using a supporting topic guide, in-depth virtual interviews were carried out with each collaborator via Zoom to gather their:

• Views on the issue and key unmet needs
• Views on current awareness and perceptions of frailty amongst practitioners and people living with HIV
• Clinical experience and practical tips for identifying, assessing and managing frailty in people living with HIV
• Key messages that need to be communicated
• Thoughts on the best format and dissemination approach

Providing simple, memorable steps to help everyone get started without overwhelming services was a key point shared by the collaborators. Therefore, the insights, experiences and suggestions from the interviews were collated together and curated into this practical and interactive guide. The ‘FRAIL in HIV’ framework was also developed to both reposition the concept of frailty in HIV to be more about increased complexity than reduced mobility and provide a memorable term that could support adoption in practice.

All collaborators have been involved in reviewing and feeding back on early versions of this draft as well as approving this final iteration. They were all reimbursed for their time spent supporting this project.