Health

Aging with HIV/AIDS

As recently as 15 years ago, most people with HIV weren’t thinking about living into older adulthood. But today — due to new, effective medications — those who are HIV positive are routinely living into their 50s and beyond with a disease that is, in most cases, considered to be a chronic condition.

And while that’s great news, older adults with HIV still need plenty of social and medical support to deal with the unique challenges that come with aging in the shadow of a chronic, life-threatening condition. “Aging successfully with HIV/AIDS is certainly possible,” says David E. Vance, PhD, MGS, assistant professor of nursing and clinical researcher at the Edward R. Roybal Center for Translational Research in Aging and Mobility. “But it’s important to recognize the many pitfalls of aging with this disease that require outside support and positive coping strategies.”

HIV is on the Rise among Older Adults

If you still think of HIV as a disease that mainly affects younger people, you should probably rethink that stereotype. “Many people are surprised to learn that adults over the age of 50 represent 15% of all new HIV cases — and we’re expecting those numbers to increase,” explains Dr. Vance. According to 2005 figures from the Centers for Disease Control, 24% of people with AIDS were over the age of 50. “It’s safe to assume that percentage is even higher in 2008,” adds Dr. Vance.

Dr. Vance explains that there are two main groups of older people with HIV/AIDS. “The first group is people who acquired the disease in their younger years and are now aging with the virus,” he says. “The second group is those who acquired the disease after age 50. There has been a significant increase in these later-life infections.”

There are several reasons for the increase in later-life HIV infections, including less perceived risk among older adults. “Many older adults still cling to the stereotype that this is a disease of the young,” adds Dr. Vance. “But in fact, HIV cuts across all ages and socioeconomic groups.”

Also, Dr. Vance says it may be easier for older adults to transmit the virus during sexual contact due to thinning of the skin and mucous membranes that naturally occurs with aging. “Related to this point, there aren’t many safe sex education programs targeted to older adults, leading this group to take fewer precautions because they may not understand the risk of unprotected sex,” he adds.

Challenges of Aging with HIV/AIDS

Cognitive Aging. Dr. Vance says that older people with HIV/AIDS seem to be at greater risk for dementia and other cognitive problems. “Taking multiple HIV-related medications, the effects of stress, and infections can have a negative impact on cognitive function among older people with HIV,” he explains.

Depression. “Older people have an elevated risk of depression — and the risk seems to increase for older people with HIV/AIDS,” says Dr. Vance. He adds that there are vast individual differences in how people respond to living with HIV, and depression may not happen to everyone. “Some people are more resilient, while others have a more difficult time.”

Difficulty Finding an Intimate Partner. “This common problem contributes to social isolation among older people with HIV — and social isolation also increases the risk of depression,” Dr. Vance explains. “Also, a partner can remind you to take your medication. If you’re alone, you may not do it. If you’re experiencing cognitive problems, this can be a downward spiral.”

Lack of Social and Spiritual Support. “Unfortunately, sources of community and spiritual support are still lacking for people aging with HIV, and this further contributes to a feeling of social isolation,” observes Dr. Vance. While he says many bodies of faith are open to gay and HIV-positive people, many others are not as welcoming. “It can be difficult for people with HIV to find the spiritual resources they need.”

Strategies for Successfully Aging with HIV/AIDS

Maintain a Positive Outlook. Dr. Vance says that while it’s true there are many challenges involved in aging with HIV, it’s important that people focus on the positive aspects of their lives. “For many people, having HIV helps them refocus their priorities — and focus out the negativity in their lives.”

Relying on Spirituality Can Help. “In my research, nearly half of those aging with HIV I interviewed reported that they considered HIV to be a blessing,” explains Dr. Vance.

Remain Socially Engaged. Staying socially connected can help to lower the risk of depression and increase overall well being. “It’s ideal for older adults with HIV to maintain close relationships with family, friends, and community groups,” Dr. Vance says.

Avoid Alcohol and Drugs. “When these substances are used as coping mechanisms, the risk of cognitive problems and depression increases,” he adds.