Seniors With AIDS and HIV

Seniors With AIDS and HIV

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The face of HIV and AIDS is changing as people with these conditions live longer.

Thomas Northcut/Digital Vision/Getty Images

With testing and treatment advancements, people with human immunodeficiency virus, or HIV, and AIDS commonly live well into middle and late adulthood. The Centers for Disease Control and Prevention reports that 30 percent of the estimated 1.1 million people in the U.S. with HIV/AIDS are age 50 or older -- a group the CDC calls "older adults" rather than "seniors." Older adults are more likely to be diagnosed later in the course of the disease than their younger counterparts and face challenges presented by both aging and living with HIV/AIDS.

HIV Transmission and Senior Sexuality

According to CDC, the main risk factors for new HIV infections in older adults are unprotected sex between men and intravenous drug use, which make up 50 percent of all new HIV cases in this age group. However, heterosexual transmission is also on the rise, particularly among women. More than 50 percent of new HIV infections in older adult women are due to heterosexual contact. Results of a national survey published in June 2008 in the "New England Journal of Medicine" indicate that 73 percent of responding adults age 57 to 64 were sexually active, as were 53 percent of respondents age 65 to 74. Older adults living with HIV/AIDS can continue to enjoy an active sex life with certain precautions. Male condoms are the only effective barrier against spreading the infection during sexual activity. Antiviral treatment also reduces the possibility of HIV transmission to an uninfected partner.

Medical Challenges

With early diagnosis and treatment, HIV/AIDS is a manageable, chronic condition for most people, including older adults. However, being HIV-positive or receiving antiviral therapy for the illness increases the risk for other serious medical conditions faced by many aging adults, including heart disease, cancer and diabetes. A study reported in the March 2013 issue of "JAMA Internal Medicine" found a 50 percent increased risk for heart attack among HIV-infected veterans compared to veterans without HIV. The National Cancer Institute reveals that certain AIDS-defining cancers are specifically associated with progression from HIV infection to AIDS: Kaposi sarcoma, non-Hodgkin lymphoma and cervical cancer. People with HIV also have an increased risk for Hodgkin lymphoma and anal, liver and lung cancers. CDC reports that diabetes is more common among older adults than younger people with HIV. Advancing age and the medications used to treat HIV increase the risk of diabetes among older adults.

HIV/AIDS Therapy

Antiretroviral therapy, or ART, is a combination of antiviral medications that slows the progression of HIV/AIDS and reduces the risk of HIV transmission. The "Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents" from the U.S. Department of Health and Human Services recommends ART for all HIV-infected adults age 50 and older. The guidelines recommend a combination of at least 3 antiviral medications taken daily. ART can cause side effects involving the liver, kidneys, nerves and other organs. Older adults may be more susceptible to some of these side effects. Because kidney and liver function tends to decline with age, older adults may metabolize and eliminate antiretroviral drugs more slowly. These drugs may also interact with medications taken for other medical conditions.

Psychosocial Impact

Research reported in the February 2011 issue of "Gerontologist" indicates that many older, HIV-positive adults feel stigmatized by their diagnosis and are more socially isolated than younger adults with HIV. A March 2013 review article published in the "American Journal of Public Health" notes that studies indicate an estimated 30 to 50 percent of older HIV-infected adults suffer from depression. However, older adults with supportive family, friends and social groups report a higher sense of self-worth, a better quality of life and greater likelihood to adhere to treatment, according to the "Gerontologist" study. Some older adults with HIV use their experiences to serve the community, while others take the opportunity to educate future generations about HIV, AIDS and risky behavior.

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