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HIV and Aging

August 2013

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Aging-Related Health Challenges

Life expectancy: In the general population, women live four to five years longer than men. HIV+ women, however, have life expectancies equal to HIV+ men. In other words, HIV+ women lose their usual longer life expectancy compared to men.

Co-morbidities: Co-morbidities refers to medical conditions that people have in addition to HIV. These include things like diabetes, liver disease, anemia, and high blood pressure. Compared to HIV-negative people, HIV+ people are more likely to have co-morbid conditions.

Heart disease: As people get older, their risk of heart attack and stroke goes up. Among post-menopausal women, heart disease can be especially serious, in part because it is still largely seen as a "man"s disease," and in part because most women who die suddenly from heart disease had no previous symptoms. Research shows that the risk for heart attacks and strokes in HIV+ people is higher than in similar HIV-negative people.

For good heart health, HIV+ people should talk with their health care providers about checking cholesterol levels, blood pressure, and blood sugar. Also consider heart-protective habits such as exercising, stopping smoking, and eating a healthy diet. For more information, see our info sheet on Caring for Your Heart.

Cancers: HIV has long been recognized as increasing the risk of certain AIDS-related cancers. Research now shows that HIV also increases the risk of non-AIDS-related cancers. These cancers include anal cancer, liver cancer, lung cancer, and Hodgkin"s lymphoma.

It is important to get regular screening for cancers known to occur more often in HIV+ people (such as cervical cancer) and for common cancers that do not appear to occur more frequently in HIV+ people (including breast, colon, and prostate cancer).

Anemia: While anemia is no longer as serious a problem as it was early in the HIV epidemic, close to one-third of all HIV+ women still experience mild anemia due to a variety of factors. Even mild anemia has been shown to decrease the chances of one"s survival while living with HIV. In older people, anemia is associated with less muscle strength, difficulty thinking, and an increased risk for falls.

Blood tests for anemia are fairly simple, and can help point to its cause. Depending on the source of your anemia, your provider will recommend appropriate treatment. Most providers regularly screen for anemia when doing routine blood work to monitor HIV disease. For more information, see our info sheet on Anemia and Women.

Bone disease: Weakened bones can occur with age, especially in women after they stop having menstrual periods. Loss of bone density can lead to osteoporosis, which weakens bones and raises the risk that bones may break. HIV+ people of both sexes are more likely to develop osteoporosis than HIV-negative individuals.

An easy and painless test called a DEXA scan can help you and your health care provider monitor your bone health and determine if you are at risk for a serious fracture. Vitamin D and calcium supplements may be recommended. Prescription medications to help reverse bone loss are also available.

For more information on specific conditions for which HIV+ people are at risk, see TWP info sheets in the Diseases and Conditions section of our website.


What Else Can You Do?

While this news may seem disheartening, it really shows that HIV+ people are now living long-enough, healthy-enough lives to die of the same types of conditions that cause death in the general population. Because people living with HIV may encounter these medical issues sooner, it is important that both HIV+ people and their providers be aware of them and take appropriate action. There is still plenty you can do to stay healthy and live a full life. Here are some suggestions to get you started:

"You Are Only as Old as You Feel"

Psychologists have shown that there is actually some truth in this. Having a positive attitude toward one"s age can have a positive effect on one"s health. Additionally, those who feel younger than their actual years tend to avoid many of the downsides associated with aging. The more credit you give yourself for wherever you are in life and the more you highlight what you CAN do, the more likely you will be to remain "young at heart."

HIV Treatment

Recent US treatment guidelines recommend that all HIV+ people older than 50 start HIV treatment, regardless of their CD4 cell count.

Many older people are already taking medications for other conditions. It is important to know if HIV drugs will interact with these medications, such as those used for high blood pressure or high cholesterol. Therefore, it is important to tell your health care provider about any over-the-counter medications, prescription drugs, herbs, vitamins, or supplements that you take so that you can identify any possible drug interactions.

Monitoring Your Overall Health

It is important for anyone over 40 to pay close attention to their health and get regular checkups. If you are HIV+, it is important to begin to keep an eye out for problems early so that you can make healthy choices as soon as possible. In addition to getting regular checkups that look for signs of the conditions listed above, be sure your checkups also look for cognitive problems (changes in thinking or memory), liver disease, kidney disease, metabolic and body shape abnormalities, diabetes, and mental health issues, including depression.


Stigma and the Need for Social Support for the HIV+ Aging Population

The aging process itself can lower energy levels, restrict social encounters, and cause decreased physical and mental abilities. This means that older HIV+ people may suffer more emotional problems and physical stresses than others do.

Stigma can also make things difficult. There is the stigma of living with HIV disease and the stigma of ageism. This can make it difficult for older people to find support. First of all, they may be ashamed and hesitate to tell anyone that they have HIV. Second, they may not be comfortable in support groups and choose not to join them.

However, it is important for older people living with HIV to seek out support. A lack of support can lead to depression. A mental health counselor, health educator, or peer counselor can help. Some peer counselors may have had similar experiences and can share healthy ways to cope.

You may find it helpful to hear the stories of older people living with HIV -- of women and men, some of whom have been HIV+ for years, and some of whom have been recently diagnosed as HIV+. There are several stories of older Americans living with HIV at The Graying of AIDS.


Taking Care of Yourself

There is a lot of research and attention focused on aging and HIV. With it may come advances in the care and treatment of older people living with HIV. In the meantime, both middle-aged and older HIV+ people need to make sure that their health care providers regularly check not only not only their HIV illness, but also for signs of diseases associated with aging. This includes testing for cancer, heart problems, bone disorders, and other health issues that are growing more common among HIV+ people as they get older.

HIV+ people can take further steps to prevent disease and improve their overall health as they age. These include getting social support, quitting smoking, eating a healthy diet, getting regular physical activity, and avoiding or reducing the use of alcohol and recreational drugs.

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This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with TheBody.com to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from TheBody.com or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.
 
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