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Surge in HIV Among Older Adults Calls for Immediate Research and Care Improvements
The landscape of HIV/AIDS in the US has evolved significantly over the years, with a notable shift towards older adults becoming a substantial part of the affected population, according to a study published in The American Journal of Medicine.
Approximately 25% of HIV infections in the US now occur in individuals over 50, a significant increase from 19% in 2001. AIDS cases in this older adult demographic have also significantly increased between 1990 and 2001. These statistics reflect a growing challenge that necessitates focused attention and research.
One of the primary concerns in addressing HIV in older adults is the delay in diagnosis and treatment. This delay leads to poorer outcomes, including lower baseline CD4 counts and increased mortality rates. Timely diagnosis and treatment are crucial in achieving outcomes comparable to those in younger patients. However, older adults are often excluded from clinical trials of newer HIV medications, which makes understanding the effects of complicated medication regimens on this group challenging.
In response to the changing demographics of HIV cases, the Centers for Disease Control and Prevention (CDC) has recommended routine HIV testing for all patients aged 13 to 64 years, likely increasing the number of diagnoses in older adults.
Research on older HIV-infected adults has predominantly focused on socioeconomics, quality of life, and access to care and services. While age does not necessarily correlate with a greater use of services, functional capacity emerges as a more critical predictor of an individual's ability to access healthcare services. Notably, women constitute a larger percentage of older adults with HIV, and older HIV-infected adults often experience challenges in emotional and practical support due to perceived stigma and a lack of available family and friends.
Because the aging population living with HIV presents unique challenges that demand increased attention and research efforts, HIV testing should be integrated into routine healthcare screenings for older adults, and healthcare providers should be vigilant in screening for medical comorbidities and consider HIV a potential cause of dementia in the elderly. Addressing these challenges and ensuring timely diagnosis and treatment for older adults living with HIV is essential to improve their quality of life and long-term outcomes.
"As older HIV-positive patients in the 21st century continue to live longer, much-needed areas of basic science and clinical research need to be addressed to direct the multidisciplinary care of this growing patient population," said researchers.
Reference
Martin CP, Fain MJ, Klotz SA. The Older HIV-Positive Adult: A critical review of the medical literature. The American Journal of Medicine. 2008;121(12):1032-1037. doi:10.1016/j.amjmed.2008.08.009