Aging with HIV: A Growing Concern

According to the Centers for Disease Control and Prevention (CDC), in 2014, nearly 17% of new HIV diagnoses were in the over-50s.

“During 2010—2014, the annual estimated number and rate of diagnoses of HIV infection in the United States remained stable,” the CDC’s 2014 HIV Surveillance Report states. Data from the report also show that 7,391 of 44,073 new HIV diagnoses in the United States in 2014 occurred in people aged 50 and older.

Although people aged 50 and older have many of the same HIV risk factors as younger people, they may be less aware of their HIV risk. Many factors probably contribute to why older people continue to become infected with HIV. Those who have been recently divorced or widowed after a long-term, monogamous relationship may not fully understand the risk of HIV infection—and older heterosexual people, especially postmenopausal women, may not use condoms during sex. In addition, older people rarely discuss their sexual activity with their physicians. Physicians are also often reluctant to discuss this topic with older patients and infrequently consider HIV when treating them.

Scientific advances in recent decades have helped HIV-infected patients live longer and better quality lives. In fact, many individuals with HIV who are retained in appropriate care can expect to have a near-normal lifespan. However, these substantial improvements are not always apparent when survival data are categorized by age.

Of particular concern is the fact that the CDC’s 2014 report indicates that survival decreased as age at HIV diagnosis increased, particularly among individuals aged 50 years and older at the time of diagnosis. In fact, 37% of the 6,955 deaths related to AIDS in 2013 were among individuals aged 50 and older.

HIV infection also presents special challenges in older age groups. Older people are more likely to be diagnosed with HIV later in the course of their disease and may also have other health conditions. As they age, HIV-infected patients also have a higher risk of chronic illnesses such as heart disease or non—AIDS-defining cancers.

Older HIV patients must therefore maximize prevention efforts against these chronic conditions and should discuss any signs or symptoms of these illnesses with their physician. And because interactions between antiretroviral agents and other drugs used in the elderly are common, older patients must be aware of any interactions between the medications they take to treat HIV and those they take for chronic conditions such as hypertension and diabetes.

The health needs of older patients with HIV therefore represent a significant public health issue. In an effort to address this growing concern, the “CDC and its partners are pursuing a high-impact prevention approach to advance the goals of the National HIV/AIDS Strategy, maximize the effectiveness of current HIV prevention methods, and improve surveillance among older people in the United States.”

Dr. Parry graduated from the University of Liverpool, England in 1997 and is a board-certified veterinary pathologist. After 13 years working in academia, she founded Midwest Veterinary Pathology, LLC where she now works as a private consultant. She is passionate about veterinary education and serves on the Indiana Veterinary Medical Association’s Continuing Education Committee. She regularly writes continuing education articles for veterinary organizations and journals, and has also served on the American College of Veterinary Pathologists’ Examination Committee and Education Committee.