On September 18, 2008, The AIDS Institute launched National HIV/AIDS and Aging Awareness Day (observed annually on September 18th) as a way to raise awareness of the challenges faced by aging populations with regards to HIV prevention, testing, care, and treatment.
Most new HIV diagnoses in the US are among young adults aged 25-34. However, in 2018, nearly 4,000 new HIV diagnoses were in adults aged 55 and older. The good news is diagnoses among older adults is declining overall. Additionally, for every 100 people aged 55 and older living with HIV, 69 have received some HIV care, 56 were retained in care, and 60 were virally suppressed, meaning they have effectively no risk of sexually transmitting HIV to a partner.
There are a few unique challenges to HIV prevention among older populations. Older people in the US are more likely to have a late-stage HIV infection at the time of diagnosis compared to younger people. This means they start treatment late and possibly have already suffered more immune system damage. Because older people may not consider themselves at risk, they do not seek out testing, and healthcare providers may not always test for HIV in older adults. Among people aged 55 and older who received an HIV diagnosis in 2015, 50% had been living with HIV for over four and a half years before being diagnosed. This is the longest diagnosis delay for any age group.
It is also important to acknowledge that, due to advances in antiretroviral treatment (ART) that keep HIV well-controlled, those living with HIV for many years (often considered “long-term survivors”) are aging into the “senior citizen” category, which presents its own unique set of barriers.
Even with their disease in control, people with HIV can develop aging-related conditions such as cardiovascular disease, osteoporosis, and cognitive impairment at accelerated rates compared to their HIV-negative peers. While medication helps keep HIV under control, the immune system is still working hard to staying healthy.
Additionally, some people living with HIV who have been taking ART since the 1990s may now be experiencing long-term effects of treatment. A common example is a medication that may increase cholesterol, putting a strain on the liver and kidneys.  As patients age, they may need to take more medications for other health issues. It is important that all of the patient’s healthcare team understands what medications might interact with certain HIV medications, causing one or both to lose their effectiveness.
If you are someone living with HIV, here are some tips on making the most out of your healthcare, regardless of age:
- Keep all of your medical appointments. You can use a calendar or set reminders on your phone. If you’re still concerned you won’t remember, don’t be afraid to ask a friend or family member to help you.
- Be prepared for your medical appointments. This might include writing down any questions you have, noting any symptoms or problems you’re having, and bringing an up-to-date list of medications you use.
- Talk openly and honestly with your healthcare provider. Your provider should be there to help, not judge. Being honest about your strengths and struggles related to your health will help your provider more effectively manage your care and treatment.
- Keep track of your results. Stay organized. Try to have the following together and easily accessible: copies of your lab results, medical visits, appointment dates and times, medicines and medicine schedules, and care and treatment plans.
For a more detailed list of things to keep in mind when visiting your healthcare provider, visit hiv.gov.
It is also important to maintain your physical health to the best of your ability beyond just medical visits. Regular exercise helps your body maintain muscle mass, increase energy, and improve blood circulation. It also boosts your immune system so it can better fight infections. Eating a balanced, nutritious diet supports overall health. Keeping a healthy weight can help your body better absorb HIV medications. And of course, refrain from drug and alcohol use, which can weaken the immune system and cause liver damage.
The CDC has enacted the High Impact HIV Prevention plan, which includes access to HIV testing, linkage to care, and prevention services. Caring Communities works hard to provide access to these services throughout our twelve-county service area. We offer free and confidential HIV testing. We also offer free link-to-care and case management services for those living with HIV/AIDS who may need help navigating the healthcare system.