Caring for Older Adults with the Human Immunodeficiency Virus

Abstract

Increasing proportions of older adults are living with the human immunodeficiency virus (HIV). It is estimated that more than 50% of individuals with HIV in the United States are aged 50 and older. Part of this group consists of individuals who have aged with chronic HIV infection, but a large proportion also results from new HIV diagnosis, with approximately 17% of new HIV diagnoses in 2013 occurring in individuals aged 50 and older. Although many of the recommendations on management of HIV infection are not age-specific, individuals with HIV aged 50 and older differ from their younger counterparts in many aspects, including immune response to antiretroviral therapy, multimorbidity, antiretroviral toxicities, and diagnostic considerations. This article outline these differences, offers a strategy on how to care for this unique population, and provides special considerations for problem-based management of individuals with HIV aged 50 and older.

Predictors of transitions in frailty severity and mortality among people aging with HIV

“…Recent reviews have summarized what is known about frailty and age-related health conditions in people living with HIV [ 4 – 6 , 13 , 14 , 37 – 39 ]. Most studies use modified versions of the Fried frailty phenotype instrument [ 13 , 40 , 41 ], which classifies people as “frail”, “pre-frail”, or “robust”/”not frail”.…”

“…As the HIV-positive population continues to age, understanding of the aging process, risk for age-related diseases, geriatric syndromes, and frailty among people with HIV becomes even more important [ 39 ]. Higher rates of many different age-related comorbidities have been identified among people aging with HIV compared to general population rates [ 1 – 3 , 5 ].…”

“…The available evidence suggests that the aging process might differ in some ways among people living with HIV, and might be modestly accelerated in general. People aging with HIV represent a highly heterogeneous group in terms of health status and risk factors [ 39 ]. Exploration of the present model of biological aging in other datasets is needed, as well as further longitudinal studies of ageing and health among people with HIV.…”

Establishing the feasibility, acceptability and preliminary efficacy of a multi-component behavioral intervention to reduce pain and substance use and improve physical performance in older persons living with HIV

“…Older persons living with HIV (PLWH), often defined as age ≥ 50 years, represent a rapidly growing population. More than 50% of PLWH in the U.S. are ≥ 50 years, (Sangarlangkarn & Appelabaum, 2016). Furthermore, older PWLH have high rates of multimorbidity (Sangarlangkarn & Appelabaum, 2016;Kim & Ritchie, 2016).…”

Strategies for improving the lives of US women aged 40 and above living with HIV/AIDS: an evidence map

“…Ideally, the care of older women living with HIV/AIDS should support patient-centered approaches to managing HIV and comorbidities; incorporate patient goals, including quality of life issues; and integrate biomedical, behavioral, and social interventions [ 13 , 30 , 31 ]. Because people with HIV/AIDS may have an accelerated aging process and often suffer from multiple comorbidities, a geriatrics approach may be appropriate, even for those who are not chronologically geriatric [ 30 , 31 ].…”