The New York Times
on Tuesday examined the medical and social implications of the increasing number of middle-aged people living with HIV/AIDS in the United States. The virus is "rapidly" becoming a disease of the middle aged, as the number of HIV-positive U.S. residents over age 50 increased fivefold during the 1990s, and a "conservative" estimate currently places that number at more than 100,000, according to Dr. Marcia Ory, professor of public health at Texas A&M University
and co-author of a 2003 CDC
report on AIDS in older U.S. residents. The demographic shift is a result of advances in antiretroviral drug treatments that help HIV-positive patients live longer, and the fact that fewer young people are becoming infected with HIV because of decreases in cases related to mother-to-child transmission and blood transfusions. The shift also is the result of people who contract HIV later in life: a 1999 CDC survey found that 44% of people living with HIV/AIDS over age 60 did not know how they contracted the virus, compared with 30% of people under age 50, according to the Times
Medical, Social Implications
"There will be some reality checking very soon," Dr. Stephen Karpiak, research director of the AIDS Community Research Initiative of America, said, adding, "People are already being assigned to nursing homes at age 55. That gets very expensive." There are various medical complications associated with older people living with HIV/AIDS because they may take more medications for conditions unrelated to HIV infection, and drug interactions can be amplified by antiretroviral drugs. Older patients also are more likely to develop diabetes or heart disease, and some antiretrovirals can increase cholesterol levels or change the way the body metabolizes insulin. Recent studies also have found that people over the age of 50 who are living with HIV/AIDS are at an increased risk of dementia, a "dangerous" complication because every lapse in adherence to a drug regimen increases a person's chance of developing a drug-resistant strain of HIV, according to the Times. In addition, doctors are more likely to misdiagnose HIV in older patients, so people over age 50 are more likely to learn their HIV status later in the disease than average and their survival rates after diagnosis are lower than younger HIV-positive people, the Times reports. The shift in HIV/AIDS demography also has social ramifications, such as poverty, isolation and separation from social networks, according to a survey conducted by Karpiak to assess the challenges associated with treating older people living with HIV/AIDS. "For a lot of the people we see, AIDS is not the most important thing in their lives," J. Daniel Stricker, executive director of ACRIA, said, adding, "A grandmother in the South Bronx may be taking care of her kids' kids and be more worried about food and shelter and just getting through the day" (McNeil, New York Times, 8/17).
Back to other news for August 17, 2004
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2004 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.