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Research suggests ACP discussions among persons living with HIV (PLHIV) are infrequent overall and may differ by gender and\/or race.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous literature has displayed that African Americans are less likely than other racial groups to use advanced care planning, palliative care or hospice, but does not conclusively account for ACP among PLHIV. African American PLHIV rely on informal care that may be differ by gender and represents an important pathway to increase ACP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>The study was mixed methods and observational.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants completed self\u2010report surveys (<jats:italic>N<\/jats:italic>\u00a0=\u00a0311) and were interviewed (<jats:italic>n<\/jats:italic>\u00a0=\u00a011). Poisson regression (quantitative) and grounded theory analyses (qualitative) were implemented, using COREQ checklist principles to ensure study rigor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Less than half had discussed ACP (41.2%; <jats:italic>N<\/jats:italic>\u00a0=\u00a0267). More ACP knowledge predicted 76% lower likelihood of ACP discussions among women. Men who spent more time caregiving in a given week were nearly 3 times more likely to discuss ACP than men who spent less time caregiving. Women were more likely than men to be caregivers and were also expected to serve in that role more than men<jats:sub>,<\/jats:sub> which was qualitatively described as \u2018being a woman\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study is one of few studies exploring ACP among caregivers in African American populations hardest hit by HIV. Results suggest that ACP skill building and education are critical for African Americans living with HIV to promote ACP discussions with their caregivers. Knowledge about ACP topics was low overall even when healthcare had recently been accessed. Support reciprocity and gender\u2010specific communication skill building may facilitate ACP in African American HIV informal caregiving relationships.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to Clinical Practice<\/jats:title><jats:p>Results underscore the need for ACP education which includes healthcare providers and caregivers, given African Americans' preference for life\u2010sustaining treatments at end\u2010of\u2010life. ACP is crucial now more than ever, as COVID\u201019 complicates care for older adults with HIV at high risk of complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.15772","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T04:55:32Z","timestamp":1617857732000},"page":"2331-2347","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["\u2018The Woman Gives\u2019: Exploring gender and relationship factors in HIV advance care planning among African American caregivers"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7447-3498","authenticated-orcid":false,"given":"Allysha C.","family":"Maragh\u2010Bass","sequence":"first","affiliation":[{"name":"Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"},{"name":"Duke Global Health Institute Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danetta","family":"Hendricks Sloan","sequence":"additional","affiliation":[{"name":"Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth V.","family":"Aimone","sequence":"additional","affiliation":[{"name":"Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"},{"name":"Duke Global Health Institute Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy R.","family":"Knowlton","sequence":"additional","affiliation":[{"name":"Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.2001.tb00294.x"},{"key":"e_1_2_11_3_1","volume-title":"Monitoring selected national HIV prevention and care objectives by using HIV surveillance data\u2014United States and 6 dependent areas, 2015","author":"Centers for Disease Control and Prevention","year":"2015"},{"key":"e_1_2_11_4_1","volume-title":"Diagnoses of HIV infection in the United States and dependent areas, 2015","author":"Centers for Disease Control and Prevention","year":"2016"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2007.07.012"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0374"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.08.019"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-012-9645-x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1989.10478792"},{"key":"e_1_2_11_10_1","volume-title":"Statistical Software \u2013 Chngpt package for change point logistic regression","author":"Fong Y. 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