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5 Ways to Improve Services for People Aging With HIV

June 8, 2016

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Credit: Roz Woodward for Photodisc via Thinkstock

People who are aging with HIV deal not only with the medical conditions common in older adults that can be compounded by HIV infection. Many also contend with ageism compounded by homophobia and HIV stigma -- besides having possibly lost many friends earlier in the HIV/AIDS epidemic. Depression is more common among older adults in general, as well as among those infected with HIV. In addition, cognitive decline in old age, which could be accelerated by chronic inflammation in the brain due to HIV, can mask the symptoms of depression.

To better address these challenges, a new report called "Strategies to Improve the Health of Older Adults Living With HIV," from the National Center for Innovation in HIV Care and other organizations recommends that organizations serving persons living with HIV/AIDS (PLWHA) who are 50 years or older take five actions:

  1. Train staff about this population's unique needs.
  2. Treat clients for comorbidities, depression and cognitive problems.
  3. Screen clients for substance use, especially tobacco use.
  4. Provide targeted sexual health education.
  5. Reduce the social isolation of this population by strengthening their social support networks.

Medical issues more likely to be experienced by older PWLHAs also include pre-existing liver problems due to the greater toxicity of first-generation antiretrovirals, cardiovascular issues from long-term use of antiretroviral therapy and a higher risk of bone fractures from the side effects of some HIV medications combined with more brittle bones in that age group.


Men who have sex with men (MSM) are less likely to have children and grandchildren and therefore might not benefit from the family-based social support networks many older adults enjoy. HIV stigma and fear of casual HIV transmission can further complicate social support relationships. Established community networks, such as those offered by African-American churches, might also not be accessible because of anti-gay stigma. Older MSM can also fear rejection by formal senior care providers, including home health aides, for their sexual orientation and might therefore not seek out such services, according to the issue brief.

"One possible solution to the social isolation of older people living with HIV is to host social opportunities for HIV-positive older adults," the report says.

The report profiles three model programs that offer support group meetings, communal meal programs and social group activities specifically for PWLHA over the age of 50.

In addition, 21% of new HIV diagnoses in the U.S. in 2013 were among people 50 years or older. This points to the need for HIV prevention interventions specifically aimed at the older population, including addressing issues of erectile dysfunction, vaginal dryness and gender imbalance in this age group. Prevention messages also must combat the belief that HIV only affects young people, the brief asserts.

The brief also includes an annotated list of resources for those providing services to older adults living with HIV.

Barbara Jungwirth is a freelance writer and translator based in New York.

Follow Barbara on Twitter: @reliabletran.

Copyright © 2016 Remedy Health Media, LLC. All rights reserved.

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