Office of National AIDS Policy Blog

National HIV/AIDS and Aging Awareness Day: Recognizing the Challenges of Growing Older with HIV/AIDS

Today marks the fifth observance of National HIV/AIDS and Aging Awareness Day.  It is a day where we recognize that while the progress made in reducing HIV mortality and morbidity is remarkable, people aging with HIV face multiple, unique challenges. By 2015 over half of all people living with HIV in the US will be over age 50. A major reason for the ‘greying’ of HIV in the US is due to the tremendous success of medications that have dramatically increased the lifespans of people living with HIV.

About 10% of new HIV infections in the United States occur among persons over 50. HIV prevention among older adults is complicated because clinicians are less likely to consider the possibility of HIV infection in this population. Part of the reason for this is that the overwhelming majority of new HIV infections in the US occur among younger populations. However, decreased testing rates mean that older adults are more likely than younger adults to be diagnosed later in their disease progression (i.e. more likely to be diagnosed with AIDS less than a year after diagnosis).

Racial and ethnic disparities observed in the US HIV epidemic overall are reflected among older persons living with HIV. The rates of HIV/AIDS among people over 50 are 12 times higher for African-Americans and 5 times higher for Latinos compared with whites, which has implications for life expectancy as well as HIV transmission because black and Latino populations generally are less likely to have access to clinical care. 

While more people aging with HIV are living healthier, more productive lives than ever before, growing older with HIV may present multiple medical challenges. Because the immune systems of people living with HIV are constantly fighting infection, they are more prone to ongoing inflammation which is associated with co-morbid conditions associated with aging such as diabetes, heart disease, hypertension, and cancer. Liver disease, often the result of co-infection with hepatitis C, is prevalent. Decreased bone density is also common, potential due to combination of the normal aging process, medication side effects, and the direct effects of the virus itself

Continuing to Fight the HIV/AIDS Epidemic

This has been an important month in the fight against HIV/AIDS: not only did we welcome people from around the world to the United States for the first time in 22 years to participate in the 2012 International AIDS Conference, but is it also the second anniversary of the release of the National HIV/AIDS Strategy. Last  week, the Office of National AIDS Policy (ONAP) released the second annual report on the progress made toward achieving the Strategy’s primary goals. 
 
As a result of the Strategy, we are we are working together and making smarter investments than ever before. It has focused and intensified Federal prevention and care resources in communities where HIV is most heavily concentrated.
 
President Obama has also made critical investments to expand access to HIV treatment and care. Since the President took office, domestic HIV/AIDS funding has increased by approximately $2.5 billion, and in his Fiscal Year 2013 Budget the President proposed $22 billion dollars for domestic HIV/AIDS programs.
 
The Affordable Care Act has already provided millions of Americans increased access to HIV testing, and will extend coverage to 30 million more Americans, including tens of thousands of people living with HIV. The Act also prohibits lifetime dollar limits on benefits, phases out annual dollar limits, and ensures no one is denied coverage based on HIV status.