HIV+ Individuals’ Health Challenges Escalate with Age: Study

TL/DR –

The U.S. healthcare system is unprepared to handle the needs of over half a million people aged 50 and over living with HIV, according to HIV advocates, doctors, government officials, and researchers. Aging with HIV increases the risk of other health issues such as diabetes, depression, and heart disease, and often requires managing multiple medications and specialists. The Ryan White HIV/AIDS Program, the federal initiative for low-income people with HIV that serves more than half of Americans living with the virus, has seen its core budget remain mostly flat since 2013 despite adding 50,000 patients.

Older Americans Living with HIV: A Growing Health Care Challenge

Malcolm Reid, a 66-year-old HIV advocate from Decatur, Georgia, recently celebrated his 28th year of living with HIV, highlighting the ever-increasing number of people aged 50 and older managing their health in the face of this virus. Reid, who has also battled kidney cancer and other health issues, is part of a group that now accounts for over half of the HIV positive population in the United States — a figure expected to rise to 70% by 2030.

With age, these individuals face an increased risk of other health problems, including diabetes, depression, heart disease, and a higher likelihood of developing these conditions at a younger age. However, the U.S. healthcare system is largely unprepared to accommodate the needs of the more than half a million people aged over 50 living with HIV.

Funding limitations, governmental dysfunction, gaps in social safety nets, lack of trained providers, and workforce shortages contribute to an environment that leaves this vulnerable population at risk. As a result, the larger fight against HIV could be undermined. “We’re at a tipping point,” warns Dr. Melanie Thompson, an Atlanta-based internist specializing in HIV care.

As people live longer with HIV thanks to antiretroviral therapies, the health risks associated with aging increase. Individuals may face “dual stigma” of ageism and anti-HIV bias, higher rates of anxiety, depression, substance abuse disorders, and the trauma of losing friends and family to the HIV/AIDS epidemic. Furthermore, many are reliant on the Ryan White HIV/AIDS Program, the federal initiative for low-income people living with HIV. The program serves more than half of Americans living with the virus, with roughly half of its clients aged 50 or older.

However, the budget of the Ryan White program has remained largely unchanged since 2013, despite serving an additional 50,000 patients. In addition, the increasing politicization of HIV could jeopardize future funding for HIV services. This includes a pilot student loan repayment program aimed at attracting infectious disease doctors to areas with a shortage of providers.

Many older people living with HIV are covered by Medicare, the public insurance program for people aged 65 and older. However, around 40% of people living with HIV depend on Medicaid, the state-federal health insurance program for low-income people. In states where Medicaid has not been expanded, older people with HIV often have limited places to seek care outside of Ryan White clinics.

In light of these challenges, HRSA recently launched a $13 million, three-year program to explore ways to improve health outcomes for older people living with HIV. This effort includes testing methods to better track the risk of adverse drug interactions, better screen for conditions like dementia and frailty, and streamline the referral process for those who may need specialist care.

However, Jules Levin, executive director of the National AIDS Treatment Advocacy Project, warns that these strategies are urgent. Aged 74 and living with HIV since the 1980s, Levin stresses, “It’s tragic and shameful that elderly people with HIV have to go through what they’re going through without getting the proper attention that they deserve. This will soon be a disaster without a solution.”

—
Read More Health & Wellness News ; US News