Global and regional trends of people living with HIV aged 50 and over: Estimates and projections for 2000–2020

Abstract

BackgroundThe increasing numbers of people living with HIV (PLHIV) who are receiving antiretroviral therapy (ART) have near normal life-expectancy, resulting in more people living with HIV over the age of 50 years (PLHIV50+). Estimates of the number of PLHIV50+ are needed for the development of tailored therapeutic and prevention interventions at country, regional and global level.MethodsThe AIDS Impact Module of the Spectrum software was used to compute the numbers of PLHIV, new infections, and AIDS-related deaths for PLHIV50+ for the years 2000–2016. Projections until 2020 were calculated based on an assumed ART scale-up to 81% coverage by 2020, consistent with the UNAIDS 90–90–90 treatment targets.ResultsGlobally, there were 5.7 million [4.7 million– 6.6 million] PLHIV50+ in 2016. The proportion of PLHIV50+ increased substantially from 8% in 2000 to 16% in 2016 and is expected to increase to 21% by 2020. In 2016, 80% of PLHIV50+ lived in low- and middle-income countries (LMICs), with Eastern and Southern Africa containing the largest number of PLHIV50+. While the proportion of PLHIV50+ was greater in high income countries, LMICs have higher numbers of PLHIV50+ that are expected to continue to increase by 2020.ConclusionsThe number of PLHIV50+ has increased dramatically since 2000 and this is expected to continue by 2020, especially in LMICs. HIV prevention campaigns, testing and treatment programs should also focus on the specific needs of PLHIV50+. Integrated health and social services should be developed to cater for the changing physical, psychological and social needs of PLHIV50+, many of whom will need to use HIV and non-HIV services.

Putting women in the centre of the global HIV response is key to achieving epidemic control!

“…The majority of these women reside in sub‐Saharan Africa, but there are hundreds of thousands living in high‐, low‐ or middle‐income regions around the world. Congruent with expanded antiretroviral treatment access, their numbers will continue to increase over the next decade . We have been complacent about understanding the biomedical changes and societal barriers for these women; and research investment is lacking .…”

Effects of ARVs and HIV on mitochondrial function and immune activation in monocyte derived macrophages in vitro

“…The number of new infections decreased 35% from 2000 to 2014 7 , and another 16% decrease from 2010 to 2018 9 . However, certain populations continue to be at high risk of infection, including men who have sex with men, people who inject drugs, and sex workers 10 . These populations are 20 times more likely to acquire the disease compared to the rest of the world population, representing 53% of new HIV infections in those who reside outside of eastern and southern Africa 9 .…”

“…These populations are 20 times more likely to acquire the disease compared to the rest of the world population, representing 53% of new HIV infections in those who reside outside of eastern and southern Africa 9 . By 2020, it is expected that 81% of the global HIV population will be on antiretroviral therapy (ART) 10 , just shy of UNAIDS's goal of 90% 9 . Also by 2020, 21% of the global HIV population will be over 50 years of age; an increase of 13% since the year 2000 10 .…”

“…By 2020, it is expected that 81% of the global HIV population will be on antiretroviral therapy (ART) 10 , just shy of UNAIDS's goal of 90% 9 . Also by 2020, 21% of the global HIV population will be over 50 years of age; an increase of 13% since the year 2000 10 . As a result, HIV has evolved from a dangerously acute and fatal disease to a more chronic disease.…”

“…By 2020, it is expected that 81% of the global HIV population will be on antiretroviral therapy (ART), and 21% of the global HIV population will be over 50 years of age; an increase of 13% since the year 2000 10 . While treatment prolongs life and substantially reduces the risk of HIV transmission, it does not completely restore health 47,48 .…”