Last week on March 3, 2015, ACRIA, in collaboration with the NYU Hartford Institute for Geriatric Nursing (HIGN) and the Center for Drug Use and HIV Research (CDUHR), hosted their annual one-day conference on HIV and Aging. One of the resounding takeaways from the conference was that the number of older adults living with HIV is rising in our country. Of the 1.25 million individuals currently diagnosed with HIV living in the United States, the CDC estimates that half of them are over the age of 50 years. This is a significant increase from 2011, when approximately 37% of the HIV positive population was over 50, and the numbers are expected to continue to rise. By 2020, it is thought that nearly 70% of individuals diagnosed with HIV will be over 50.
Older adults with HIV experience unique challenges relative to those of the HIV positive population at large. Older adults with HIV report depressive symptoms at five times the rate of the larger community, and they are developing other multiple chronic illnesses (including heart disease, cancers, diabetes, hypertension, kidney, and liver disorders) up to 20 years earlier than expected. Conference speakers noted the importance of taking into account an individual’s age when developing a treatment plan. For example, HHS guidelines recommend that an individual regardless of age get started on antiretrovirals at the time of diagnosis; however, these medications are associated with negative effects that may disproportionately affect older adults (i.e., contribute to liver failure). However, it was also noted that the fact that someone is older should not mean that certain HIV-related risk factors are discounted. Although it is estimated that one in every six new HIV diagnoses occurs in someone who is over the age of 50, providers are often uncomfortable speaking with older adults about their sexual activities. Further, HIV testing for adults over 50 occurs at only 60% of the testing occurrence rate for those who are younger.
It is clear that misunderstandings and misconceptions must be addressed if we are to adequately meet the needs of this unique and growing population. In response to this need, ACRIA, the American Academy of HIV Medicine (AAHIVM), and the American Geriatrics Society (AGS) have joined together to create the “Go-To Place on HIV and the Aging,” an online resource for those looking to learn more and/or address the challenges of managing the health of the older adult with HIV. The site, which contains relevant research, clinical practice recommendations, and a compendium of upcoming events, can be accessed via: http://hiv-age.org/