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Stanford Medicine

HIV/AIDS, Infectious Disease, Sexual Health

An aging HIV-positive population faces unique medical challenges

Medical advances have transformed HIV infection from a certain death sentence to a potentially survivable (if still incurable) disease, and the result is a growing population of middle-aged AIDS patients. An article recently published in HealthyCaladdresses some of the new and unique challenges that this population faces.

For the first time in history, Herbert A. Sample writes, physicians are treating large numbers of older HIV-positive patients:

Data released by the federal Centers for Disease Control and Prevention in 2008 showed that almost 186,000 men and women age 55 and up were living with HIV. And the latest CDC statistics, released in 2006, found that at least 10 percent of new HIV infections nationwide, and 20.5 percent of new AIDS diagnoses, were among men age 50 or older. In 1982, only 7.5 percent of new AIDS diagnoses were 50 years old or older.

These patients may be living longer than past generations of HIV-positive people, but their lives are still significantly affected. HIV-positive patients tend to age much more rapidly than healthy people and suffer age-related issues like neurodegeneration and bone-density loss earlier. And:

Older patients who are stable but whose immune systems operate less than optimally face higher odds of contracting osteoporosis, or cardiovascular, kidney or liver problems, said Dr. Peter Ruane, a Los Angeles internist who treats HIV and AIDS patients. Those complications may be result from HIV, AIDS, the caustic medicines they took early on or even safer ones that have been developed over the last 15 years, he added.

The article also discusses a small, but still significant, group of patients who contracted the virus in their 50s as opposed to having lived with the disease for decades. Since the bulk of preventative efforts have focused on the 13- to 40-year-olds who comprise two thirds of the infected population, it’s possible that older adults simply do not have access to the same safe-sex information and guidelines. Rising sexual activity in seniors and a general “I’m-old-so-it-doesn’t-matter” attitude towards condom use are also listed as possible reasons for adults contracting HIV later in life.

Previously: Stanford researchers urge caution on use of AIDS regimen, Some reflections on the 30th anniversary of AIDS
Photo by Horia Varlan

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