HIV and Older People

World AIDS Day is dedicated to fighting stigma and discrimination, and raising awareness of the HIV/AIDS pandemic. We mark this day by, in turn, raising awareness of older people with HIV.

Incidence and prevalence of HIV in older people is increasing. In the UK one in five adults with HIV is aged over 50. This is a consequence both of the expansion in uptake of HIV testing and diagnosis and major improvements in treatments which are helping people with HIV to live longer.

The fact that older people with HIV are living longer where there is access to treatment is a cause for celebration but it also brings challenges for geriatric medicine. Older people with HIV commonly experience co-morbidities such as cardiovascular disease, osteoporosis and dementia. Medical management of HIV in older people requires considerations of complex drug interactions and co-morbidities.

Early diagnosis of HIV is key to improving prognosis. Treatment with highly active anti-retroviral therapy (HAART) significantly prolongs life expectancy, however it is associated with an increased risk of side effects in older patients.

The risk factors for HIV are similar for adults of all ages, but older people may be less informed than younger people and be less likely to seek or be offered testing. For example older people may be embarrassed to discuss and acquire condoms or be may be less concerned about using one. Older women may experience age-related vaginal atrophy which can make sexual activity more of an infection risk.

There is a need for improved awareness of the potential diagnosis of HIV in older people. HIV testing of older patients should not be discounted when investigating illness. Clinicians may want to raise the issues when dealing with older people and help dispel misconceptions that they are not at risk from infection.

Explore this subject further with articles published in Age and Ageing journal:

Frailty and physical function in older HIV-infected adults 

Fatima Brañas  Zaida Jiménez  Matilde Sánchez-Conde  Fernando Dronda Juan Carlos López-Bernaldo De Quirós  María J. Pérez-Elías  Pilar Miralles  Margarita Ramírez  Ana Moreno Juan Berenguer  Santiago Moreno. 2017

The human immunodeficiency virus and ageing

Eva Bunting, Chakravarthi Rajkumar, Martin Fisher. 2014

Early diagnosis and treatment of HIV infection: magnitude of benefit on short-term mortality is greatest in older adults

Daniel H. J. Davis  Ruth Smith  Alison Brown  Brian Rice  Zheng Yin  Valerie Delpech. 2013

The ageing of HIV: implications for geriatric medicine

Fiona Kearney  Allan R. Moore  Ciaran F. Donegan  John Lambert. 2010.

Human immunodeficiency virus (HIV) in older people

Gary Pratt  Kate Gascoyne  Katherine Cunningham  Anne Tunbridge. 2010

Newly diagnosed HIV infection in an octogenarian: the elderly are not ‘immune’

Geoffrey C. Cloud  Rita Browne  Nina Salooja  Kenneth A. McLean. 2003

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