With the success of Human Immunodeficiency Virus (HIV) treatment, more people with HIV are living longer. However, aging with HIV presents unique challenges and considerations compared to the general aging population. According to a report by the Centers for Disease Control and Prevention (CDC), over half a million people in the United States living with or newly infected by HIV are older than 50. This growing group of individuals faces various health risks that require specialized care and attention from healthcare providers.
Keith Henry, MD, founder of the first HIV clinic in Minnesota and professor of medicine, emphasizes the importance of understanding how aging impacts people with HIV and how HIV can influence the aging process. He co-authored a toolkit developed by Minnesota Northstar Geriatrics Workforce Enhancement Program (MN-GWEP) to help educate health professional students on providing the highest quality care for older adults with HIV.
Rajean Moone, PhD, LNHA, faculty director for Long Term Care Administration and associate director of policy in School of Public Health's Center for Healthy Aging & Innovation, notes that as people living with HIV live longer and healthier lives, it is crucial for clinicians to understand their unique needs. The free online toolkit developed by MN-GWEP in partnership with Rainbow Health Minnesota helps educators infuse content on HIV and aging into their existing health-related courses.
Effective treatment for HIV has led to an increase in life expectancy, but geriatric HIV patients face higher rates of age-related comorbidities and hospitalizations. Decision makers will need to allocate resources, train providers, and plan ways to manage chronic diseases among this population due to increased hospitalizations. From 2003 to 2015, the proportion of HIV positive patients aged 50 years or older in the National Inpatient Sample increased from fewer than 25% to more than 50%. Khairul A. Siddiqi from the University of Florida College of Medicine reports that geriatric HIV inpatients have higher rates of diabetes and cancer comorbidities, which may require increased hospitalizations for managing chronic diseases.
People with HIV face various challenges as they age, including inflammation from the virus, long-term use of harsh medications, coordinating care across specialists, multiple prescriptions, adverse drug reactions, dual stigma (related to both aging and HIV), anxiety, depression, substance use disorders, and loneliness. The U.S. healthcare system is not prepared to handle these needs effectively due to funding constraints and workforce shortages.
The Ryan White HIV/AIDS Program is a federal initiative aimed at ending the HIV epidemic by 2030 through various strategies, including increasing access to care for underserved populations and improving the quality of care for people with HIV. Medicare and Medicaid also play essential roles in providing healthcare coverage for older adults living with HIV.
In conclusion, as more people with HIV live longer lives, it is crucial to understand their unique needs and challenges. Healthcare providers must be trained on how to provide the highest quality care for this population, focusing on managing chronic diseases and addressing the various health risks associated with aging and HIV.
