June 19, 2013
AIDS Care journal has reported that more than half of San Francisco's AIDS-diagnosed patients are 50 years old or older, stating that the city "is the first local jurisdiction to have reached this milestone." Many HIV-positive persons' prognoses now are normal, due to HIV treatment and care improvements, according to the investigators. The time period between HIV diagnosis and AIDS diagnosis also has lengthened, and people are living longer with AIDS, meaning an increasing number of people with AIDS are at or older than 50. The study also illuminated the need for HIV medicine to overlap with other medical specialties to accommodate caring for patients with already complex medical needs due to previous AIDS diagnoses.
Investigators examined San Francisco's HIV/AIDS case registry for age distribution trends of AIDS-diagnosed people living in the city between 1990 and 2010, as well as the age trends in new AIDS diagnoses throughout the same time period. For each AIDS case, the registry provided data regarding demographics and HIV risk group, opportunistic infections, HIV diagnosis date, and CD4 cell count and viral load. The investigators also used national registers to compile comparative data concerning the age distribution of people with AIDS across the United States.
At the end of 2010, San Francisco's population included 9,796 AIDS-diagnosed residents. Of these, 5,112 (52 percent) were 50 years old or older, with the proportion of people ages 50 or older increasing progressively throughout the study's 20-year time period. In 1990, only 10 percent of San Francisco's AIDS-diagnosed individuals were 50 or older; the proportion increased to 24 percent in 2000, 38 percent in 2005, and 52 percent in 2010. The United States experienced a similar trend nationwide, with the proportion of older AIDS patients rising from 20 percent in 2001 to 39 percent in 2009. The study indicated that San Francisco experienced a sharp decline in new AIDS diagnosis numbers. In 1990, health officials reported 2,047 new AIDS cases. The figure decreased to just 331 cases in 2010. Also, the age profile for people newly diagnosed with AIDS changed. The authors reported two reasons for their findings: peoples' increasing age at the time of their AIDS diagnosis, and antiretroviral therapy's success in reducing AIDS mortality.
The full report, "People Fifty Years or Older Now Account for the Majority of AIDS Cases in San Francisco, California, 2010," was published online in the journal AIDS Care (2013; doi: 10.1080/095401212.2012.752565).