Aging with HIV: Evolving Challenges Impacting the Community
Posted: September 12, 2019 | Word Count: 831
When Jeff Taylor was diagnosed with HIV in 1988, he was told he had two years to live.
“The doctors suggested I start making arrangements because there were limited treatment options available then,” said Taylor, who is now the co-chair of the community advisory board of the amfAR Institute for HIV Cure Research, and the executive director of the HIV+Aging Research Project — Palm Springs. “In the 80s and into the 90s, there was a very narrow understanding of HIV. I began attending meetings with community advocates to share what little information there was, but we were all eager for more.”
Since those early days of the epidemic, society’s understanding of HIV and advances in scientific innovation have greatly evolved. HIV has essentially transformed into a chronic health condition that can be managed effectively with treatment. Today, the average life expectancy for most people living with HIV is about as long as that of the general population.1 Now, like everybody else, people living with HIV face a new challenge — aging.
Since 2000, the number of individuals over the age of 50 currently living with HIV has nearly tripled. In 2016, there were an estimated 5.7 million people over 50 living with HIV across the globe, and that number is projected to continually increase through 2020.2 In the U.S., an estimated 48% of people with diagnosed HIV were 50 or older.3
“For decades, I have struggled and watched others grapple with the challenges that come with aging with HIV, including the physical toll of a lifetime of treatment alongside having to manage age-related conditions like diabetes, high blood pressure, heart disease, cancer, inflammation and neurocognitive decline. Not to mention the psychological effects of living when so many were lost in the fight against this epidemic,” said Taylor.
Taylor also notes that aging well with HIV — specifically the long-term effects of antiretroviral therapy — is a concern that impacts all age groups. In 2017, the highest rate of HIV incidence in the U.S. was among people aged 25 to 29 years, and the second-highest rate was for people aged 20 to 24 years.4 People are now living longer with HIV, so those who are exposed in their 20s must think about what it means to be on antiretroviral therapy for their entire adult life.
Peter Shalit, M.D., Ph.D., an Internal Medicine physician in private practice and Clinical Professor of Medicine at the University of Washington School of Medicine, has treated people of all ages living with HIV throughout his nearly 30-year career. “Many people living with HIV worry about the long-term effects of HIV medicines; as the average age of my patients is over 60, I hear about these concerns firsthand.5 Working together, we can consider treatment options that will hopefully address their concerns, including therapies that allow them to take fewer drugs.”
As the HIV community ages, it’ll be important to focus efforts on helping individuals achieve their long-term health goals. ViiV Healthcare, a company that’s solely focused on HIV, runs and supports several studies and community programs that aim to build a deeper understanding of the clinical, scientific and societal effects of HIV on aging.
“Putting time, energy and resources into determining HIV treatments and care that will promote healthy aging is a worthwhile investment,” said Taylor. “Clinical trials were a lifeline for me and I’m incredibly grateful to the research community, as their advancements have allowed me to stay alive. I’m committed to seeing this virus end with me and my generation and believe continued research is the solution to stopping this once and for all.”
- Samji H, et al. Closing the Gap: Increases in Life Expectancy among Treated HIV-Positive Individuals in the United States and Canada. PLoS One. 2013; 8 doi: 10.1371. Accessed April 26, 2019. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24367482?dopt=Abstract.
- Autenrieth CS, et al. Global and regional trends of people living with HIV aged 50 and over: Estimates and projections for 2000-2020. PLoS One. 2018;13(11):e0207005. doi:10.1371/journal.pone.0207005. Published November 29, 2018. Accessed April 26, 2019. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6264840/.
- Centers for Disease Control and Prevention. Diagnoses of HIV Infection in the United States and Dependent Areas, 2017. HIV Surveillance Report, 2017; vol. 29. Table 22a, page 98-99. Published November 2018. Accessed April 26, 2019. Available at: https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2017-vol-29.pdf.
- Centers for Disease Control and Prevention. Diagnoses of HIV Infection in the United States and Dependent Areas, 2017. HIV Surveillance Report, 2017; vol. 29. Table 1a, page 17. Published November 2018. Accessed April 26, 2019. Available at: https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2017-vol-29.pdf.
- Positive Perspective Survey, 2017. ViiV Data on File. Accessed on April 26, 2019. Available at: http://gskvideo.edgesuite.net/Viiv/viivhealthcare/pdf_files/master/main/positive-perspectives-survey-report-finalcompressed.pdf.