While improvements in treatment are helping people live longer with HIV, many people face medical, social, and financial challenges as they age.
The first case of HIV-related illness in the United States was reported in 1981. For years, treatment options remained limited, and many people died from HIV-related illnesses shortly after receiving the diagnosis.
The development of highly active antiretroviral therapy (ART) has greatly improved survival and quality of life for people with HIV while also reducing transmission of the virus. Now, more than half of people in the United States who have an HIV diagnosis are 50 years old or older.
Aging with HIV can come with challenges. Older adults with HIV can face delayed diagnosis and an increased risk of certain health conditions, as well as the potential for social isolation. Many also experience economic difficulties.
Patient advocates, researchers, healthcare professionals, government agencies, and other community members all have roles to play in helping older adults with HIV thrive.
Read on to learn more about the challenges facing this community.
Adults who contract HIV later in life often experience delays in diagnosis, which can delay treatment and raise the risk that HIV will progress to stage 3, also known as AIDS. That progression happens when the immune system becomes too damaged to fight off opportunistic infections.
A 2024 report from the Centers for Disease Control and Prevention (CDC) provides information about people who received an HIV diagnosis in 2022. According to this report:
- 55.6% of adults who were 45 to 54 years old at the time of diagnosis had stage 3 HIV
- 36.4% of adults who were 55 to 64 years old at the time of diagnosis had stage 3 HIV
Adults who were under 45 years old were more likely to get their HIV diagnosis at an earlier stage, when treatment can help prevent progression to stage 3 HIV.
According to the National Institutes of Health, multiple factors may contribute to delays in diagnosis among older adults with HIV.
Healthcare professionals might be less likely to recommend HIV testing to older adults because of assumptions about their sexual activity or needle-sharing practices. Some older adults might avoid getting tested out of embarrassment or fear. And some might mistake HIV symptoms for symptoms of age-related health conditions or common signs of aging.
The
- engage in sex without a condom or another barrier method
- have multiple sexual partners
- have a sexual partner who has multiple partners
- share needles or have a partner who shares needles
You can visit GetTested to find an HIV testing site near you.
Older adults in general have an increased risk of developing severe respiratory illness from viral infections such as:
- COVID-19
- influenza (flu)
- respiratory syncytial virus (RSV)
HIV can add to the risk of respiratory illness in older adults by weakening the immune system. The risk is particularly high in those who have a low CD4 count (a measurement of the number of a certain type of white blood cells in the blood) and those who aren’t getting effective treatment for HIV.
If you have HIV, it’s important that you receive ART treatment to lower the amount of virus in your blood and limit damage to your immune system. This treatment can help prevent severe illness from respiratory infections.
Other strategies to
- getting recommended vaccinations
- avoiding close contact with people who are sick
- wearing a face mask
- washing your hands often
- cleaning surfaces and objects that get touched frequently
You can talk with a doctor to find out which vaccines they recommend for you.
If you have HIV and think you might have an infection, you should contact a doctor right away.
People with HIV have an
- heart disease
- type 2 diabetes
- chronic liver disease
- chronic kidney disease
- chronic lung disease
- cancer
They tend to develop these conditions at a younger age than average, even when they get treatment for HIV.
HIV causes systemic inflammation, which contributes to these health conditions. ART treatment can help reduce inflammation, but people who take ART for HIV still have more inflammation than people without HIV. Researchers are still studying why this happens and how to reduce the inflammation.
People with HIV often experience psychological and social stress, which can make it harder to stick with a treatment plan. As a result, they may face gaps in treatment and increased systemic inflammation. Improving treatment access and support for people who face these challenges is an important goal.
Although ART is essential for treating HIV, it can
Attending regular medical checkups can help older adults with HIV manage the risk of treatment side effects and other health conditions. A doctor will ask questions and order tests to check for changes in their health. A doctor may recommend lifestyle or treatment changes to manage new treatment side effects or health conditions.
If you have HIV, you should let your doctor know about any changes in your health, including new health conditions or new treatments you’re receiving. Some health conditions may affect the risks of taking certain types of ART, and some medications may interact with each other and increase the risk of side effects.
Social isolation and loneliness are
Older adults with HIV may encounter HIV-related stigma, including prejudice, discrimination, or mistreatment. This stigma can negatively affect personal relationships and make it harder to build and maintain social networks.
Some older adults with HIV are members of communities that lost many people to the virus during the height of the epidemic in the late 1970s and the 1980s. These losses may also
Joining a virtual or in-person support group for people with HIV may help older adults connect with peers and members of younger generations. Other strategies for social connection include:
- connecting with others through social media
- participating in a peer mentorship program
- joining a social club or community group
Pursuing individual hobbies or interests may also help some older adults with HIV find joy and purpose while managing social isolation and loneliness.
The cost of treating HIV and other health conditions adds up over time.
Barriers to employment may also contribute to financial challenges among older adults with HIV.
A 2018 study found that 44% of younger adults with HIV had employment, as compared with 74% of younger adults without HIV. The same study found that 24% of older adults with HIV had employment, while 50% of older adults without HIV did. In this study, the category “older adults” included those who were 50 years old and older.
Financial challenges may limit people’s access to HIV treatment and other medical care. It may also affect access to elder care, safe housing, food, and other essential resources.
Funding of social programs is essential for helping older adults with HIV manage economic challenges and access essential resources.
Treatment with ART has significantly improved the outlook for people with HIV, including adults ages 50 years old and older, who make up a growing proportion of people with this virus.
While some older adults have been living with HIV for decades, others have contracted the virus later in life. People who contract HIV later in life often experience delays in diagnosis. Limiting those delays is important for improving HIV treatment rates and outcomes.
Older adults with HIV have an increased risk of developing certain health conditions, such as severe respiratory illness and heart disease. Regular medical checkups are essential for managing the risk of these health conditions. A doctor may recommend lifestyle changes or treatment to reduce these risks.
Social isolation, loneliness, and stigma also contribute to the challenges for older adults with HIV. Some people might find it helpful to join a support group, peer mentorship program, or social club.
Financial challenges can make it harder for older adults with HIV to access medical treatment, elder care, and other essential resources. Investment in social programs is important to help people manage these difficulties.
People can connect with an HIV patient organization to learn more about services and programs for older adults with HIV and opportunities to get involved in HIV advocacy efforts.