The number of people with HIV worldwide who are 50 or older is likely to almost double by 2040, skyrocketing from 11.5m to 20.2m, a new report from The Lancet, presented last week in Rio de Janeiro at the 26th International Aids Conference, warned.
At that stage, said the authors, the numbers would represent more than half of all people with HIV, and pose new challenges for health systems unprepared for their specific needs, reports Business Day.
More than 95% of these people will be in low- and middle-income countries. In South Africa, the number is projected to rise from 2.3m (HIV+ over-50s) to 3.9m.
The report said that generally, HIV care centres mainly around ensuring people survive, focusing on diagnosis and treatment, but as they age, they require care that takes into account the growing likelihood that they may also have age-associated conditions like diabetes, cardiovascular disease, cancer and liver disease.
“There are unique aspects of ageing with HIV,” said study co-author Amy Justice, professor of public health at Yale University. “There is a general belief that once people are on antiretroviral therapy, their life expectancy is just like everyone else’s, but that is absolutely not the case.”
Many people with HIV have a higher physiological age than their chronological age, said study co-author Keri Althoff from the Bloomberg School of Public Health at Johns Hopkins University.
She added that survivors of the early stages of the HIV pandemic, who could not start treatment immediately, carry a “biological debt”, with chronic inflammation and a dysregulated immune system, and suggested that care for older adults should include HIV screening, which is often overlooked due to stigma and ageism. “Older adults also get HIV,” she pointed out.
Althoff noted the limited safety data on HIV prevention drugs for this age group, and said researchers should consider older people’s needs, too – and that landmark clinical trials for pre-exposure prophylaxis have traditionally enrolled mostly younger people and under-represented older adults.
See more from MedicalBrief archives:
HIV among older South Africans neglected – Wits-Harvard study
HIV risk-taking behaviour by older adults in SA