People are living long lives with HIV care, but it is important to acknowledge aging-related challenges of HIV prevention, testing, treatment, and care.
Today, September 18, 2019, is National HIV/AIDS and Aging Awareness Day.
The US Centers for Disease Control and Prevention (CDC) indicates that nearly half of people in the United States who are diagnosed and living with HIV are aged 50 years and older. In 2016, 6812 of the 39,782 new HIV diagnoses (17%) were in individuals over 50 years.
Every year National HIV/AIDS and Aging Awareness Day is commemorated as a day to call attention to the fact that people are living long lives with HIV and also to acknowledge aging-related challenges of HIV prevention, testing, treatment, and care.
Statistics indicate that in 2016, 49% of new HIV diagnoses in older adults were among men who have sex with men, 15% were among heterosexual men, 24% were among heterosexual women, and 12% were in people who inject drugs.
Additionally, 42% of new cases in 2016 were documented in black individuals, 37% in white individuals, 18% in Latinos, and 4% in other races and ethnicities.
One particular challenge in this patient population is that older individuals in the United States are more likely to have late-stage infections at the point of diagnosis. According to the CDC, in 2016, 35% of the older adults diagnosed with HIV already had AIDS. While this figure is high, it demonstrates progress from 2011, when 42% of older adults with new HIV infection already progressed into late-stage illness.
Late-stage diagnoses are challenging because when patients begin treatment late, they often experience more immune-system damage.
These late diagnoses may occur because clinicians may not always test older adults for HIV infection and older individuals may not consider themselves at risk for HIV. Furthermore, symptoms of HIV may be mistaken as normal aging symptoms. In 2015, among individuals 55 years and older who were diagnosed with HIV, 50% had been HIV-positive for 4.5 years before their diagnoses, which is the longest delay for any age group.
The CDC recommends that Americans aged 13 to 64 years old get tested for HIV at least once as part of routine health care and that people at higher risk of infection get tested more often. Providers may recommend HIV testing for individuals over 64 years who are at risk for HIV infection.
In order to protect against HIV infection, older adults should be aware that they have the same HIV risk factors as younger individuals; therefore, HIV prevention and facts about sexual risks should be disseminated to older patients. The CDC reports that older people are less likely than younger people to discuss sexual or drug use behaviors with their clinicians and clinicians are less likely to ask older patients about these behaviors.
Both age and HIV infections increase an individual’s risk for cardiovascular disease, bone loss, and certain cancers. Older people living with HIV and their care providers should be vigilant for early signs of illness and employ preventative measures against these conditions. There is also a risk of drug-drug interactions between HIV treatments and treatments for hypertension, diabetes, high cholesterol, and obesity.
In order to encourage older adults with HIV to seek care and disclose their status to their health care providers, it is important to avoid stigmatizing words and actions, the CDC notes.
On National HIV/AIDS and Aging Awareness Day and everyday it is important to acknowledge that individuals with HIV are living longer due to effective antiretroviral therapy. However, it is important to acknowledge challenges to aging with HIV and promote collaborative and supportive care for all.