September 18th of each year has been designated as the National HIV/AIDS and Ageing Awareness Day (NHAAAD), to call to attention the challenges that older Americans face in terms of HIV prevention, testing, care, and treatment, and to recognize the impact of HIV on those ageing with HIV. The day was launched in 2008 by lead organizer, the AIDS Institute.
The Centers for Disease Control and Prevention (CDC) reports that people aged 55 and older accounted for 26% of the estimated 1.2 million people living with diagnosed or undiagnosed HIV infection in the US in 2013. HIV is too often diagnosed in older adults late in the course of infection, leading shorter HIV to AIDS intervals. The CDC reports that in 2014, 40% of people aged 55 and older were diagnosed with AIDS at the time of HIV diagnosis.
The face of HIV/AIDS is graying, and as of 2015, 50% of people with HIV in the US were 50 or older. By 2020, more than 70% of Americans with HIV are expected to be 50 and older.
LGBT people and people of color are disproportionately impacted by HIV/AIDS. Out of every 100,000 people diagnosed with HIV in 2013, 59% of African-Americans were older. That number was 29% for Hispanics, and nearly 9% for whites.
Americans over 50 have many of the same HIV risk factors as younger Americans. For example, research shows that heterosexual and LGBT older adults are sexually active well into their mid-80s. Other risk factors that stay the same as age increases are having multiple partners, and a lack of knowledge and how to prevent it.
Some unique challenges are that women are no longer worried about getting pregnant, so don’t feel the need to practice safer sex; older people and their doctors are less likely to talk about the patient’s sexual habits; and medical providers assume that older adults are no longer sexually active, so do not test them for HIV.
Ageing with HIV also creates special challenges for preventing and treating other diseases, such as an increased risk for cardiovascular disease, thin bones, and certain cancers.
Older adults also need to be careful about interactions between the medications they use to treat HIV and those used to treat common age-related conditions such as hypertension, diabetes, elevated cholesterol, and obesity.