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Older People and HIV

Fact Sheets and Infographics

HIV and Older People (HIVinfo) – This fact sheet examines how HIV affects older people, their risk factors for HIV infection, recommendations for HIV testing, and considerations regarding HIV treatment in older people. Also available in Spanish.

HIV in the United States by Age (CDC) – This web page links to data on HIV among different age groups, including people age 55 and older. Information is provided on HIV risk behaviors, pre-exposure prophylaxis (PrEP) coverage, HIV incidence, HIV diagnoses, knowledge of HIV status, viral suppression rates, prevention challenges, and what CDC is doing to address HIV in different age groups.

Aging with HIV (HIV.gov) – This fact sheet provides background information about growing older with HIV, the health complications that may occur with aging, the consequences of long-term HIV infection, and the relatively high rate of late HIV diagnosis among older people with HIV. There is also a brief discussion about the importance of support services for older people with HIV.

HIV, AIDS, and Older Adults (National Institute on Aging) – This fact sheet in question-and-answer format gives information about what HIV and AIDS are; HIV transmission, testing, and symptoms; and ways HIV is different in older adults compared to younger persons.

Ten Things Every LGBT Older Adult Should Know About HIV/AIDS (SAGE) – This fact sheet includes background information about HIV infection and its effects on older adults, populations at greatest risk, stigma and discrimination, HIV prevention, talking with providers, LGBT-affirming health care, and support networks.

HIV and Aging Infographics from AIDSVu

HIV Surveillance Reports and Data Analyses

Diagnoses of HIV Infection in the United States and Dependent Areas, 2020 (CDC) – This surveillance report includes detailed information about new HIV diagnoses, prevalence, and deaths among older persons, as well as persons in other age categories. Breakdowns are also provided by gender, race/ethnicity, transmission category, and geographic region. Many tables in the report include data breakdowns by age. The age categories included for older adults are: 50 to 54, 55 to 59, 60 to 64, and 65 years and older.

Estimated HIV Incidence and Prevalence in the United States, 2015-2019 (CDC) – This report provides estimates of the number of new HIV infections and the total number of persons living with HIV during each year from 2015 through 2019. It begins with a commentary section that summarizes highlights of the report, followed by tables that present data on HIV incidence and prevalence among adults and adolescents, with breakdowns by age, sex at birth, race/ethnicity, transmission category, and region of residence. The age data include statistics for older persons aged 55 years and above. An appendix focuses on the estimated incidence and prevalence of HIV infection among adults and adolescents living in Ending the HIV Epidemic (EHE) Phase 1 jurisdictions.

Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data United States and 6 Dependent Areas, 2020 (CDC) – This report presents the results of focused analyses of U.S. HIV surveillance data to measure progress toward ending the HIV epidemic. It includes information on the stage of HIV disease at the time of diagnosis, linkage to HIV medical care, viral suppression, prevalence-based HIV care continuum, HIV deaths and survival, PrEP use, and perinatal HIV infections. For some measures, data are broken down by age, as well as gender, race/ethnicity, transmission category, and area of residence.

Estimated HIV Incidence and Prevalence in the United States, 2010-2019 (CDC) – This slide set summarizes trends in HIV incidence during the 2010s, with breakdowns by age, sex, race/ethnicity, transmission category, and region. Data for 2019 is also provided on knowledge of HIV status, as well as HIV prevalence in the 50 states, District of Columbia, and Puerto Rico.

HIV Infection, Stage 3 (AIDS), 2020 (CDC) – This slide set summarizes trends in AIDS diagnoses and deaths from 1985 to 2020, with breakdowns by age, sex, race/ethnicity, transmission category, and region. Data on cumulative AIDS diagnoses and deaths through 2020, and AIDS data for Metropolitan Statistical Areas are also provided.

HIV Mortality: 2020 (CDC) – This slide set presents an analysis – in a series of charts, graphs, and maps – of trends in the rates and distribution of deaths among people with HIV disease. Breakdowns are provided by age, gender, race/ethnicity, and geographic region.

 

Materials from the Health Resources and Services Administration

Older Adult Clients: Ryan White HIV/AIDS Program, 2020 – This fact sheet summarizes selected demographic and health characteristics of adults aged 50 years or older in the Ryan White HIV/AIDS Program (RWHAP). Nearly half (48%) of all RWHAP clients were over 50 during 2020. Of these older clients, 59% had incomes at or below the Federal Poverty Level, about on in 30 (3.6%) experienced unstable housing, and 93% were virally suppressed. More detailed information is provided about these and other demographic characteristics. A related slide deck provides an overview of key data for RWHAP clients aged 50 years or older in a series of graphs.

Optimizing HIV Care for People Aging with HIV: Incorporating New Elements of Care – This guide provides background information about older people with HIV, and highlights the specific health and social challenges, gaps in medical management, and health screening tools available for this group. An extensive list of references is also included. According to HRSA’s HIV/AIDS Bureau, this guide “serves as a starting point for health care teams as they build and expand their knowledge and practice of serving people aging with HIV.” 

Optimizing HIV Care for People Aging with HIV: Putting Together the Best Health Care Team – This guide outlines a multi-disciplinary approach for providing high-quality HIV care to older people with HIV. It focuses on the roles and responsibilities of different health care providers who serve older people with HIV, the specific staff training needs of those serving older people with HIV, and the organizational capacity and resources necessary to ensure that older people receive optimal HIV care.

Addressing the Health Care and Social Support Needs of People Aging with HIV – This issue brief discusses considerations for providing HIV medical, psychosocial, and support services to people aging with HIV; opportunities for improving health care services and social support for people aging with HIV; how RWHAP recipients can improve services for people aging with HIV; and workforce issues for people aging with HIV.

Aging with HIV: CARE Challenges – The April 2018 issue of the HRSA CARE Action newsletter focuses on aging with HIV, including HIV diagnosis and treatment for older persons, comorbid conditions, RWHAP-funded programs that address HIV and aging, and HIV treatment guidelines for older adults.

 

Recommendations, Reports, and Websites

Considerations for Antiretroviral Use in Special Patient Populations: HIV and the Older Person (Clinicalinfo.HIV.gov) – This section of the U.S. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV focuses on key considerations when caring for older people receiving HIV treatment.

HIV & Aging (University of Minnesota) – This toolkit contains resources for teaching future and current clinicians about HIV and care for older adults. It contains introductory material appropriate for undergraduate and graduate level learners and is intended to help clinicians provide the highest quality care for older adults with HIV.

SAGE: Advocacy & Services for LGBT Elders – This website includes an HIV/AIDS section with the following fact sheets and issue briefs that focus on HIV and aging, with particular emphasis on LGBT people:

 

Olvidados – Illuminating the Needs of the Forgotten: A National Health Assessment of Latinos Growing Older with HIV (Latino Commission on AIDS and Hispanic Health Network) – This report summarizes the health concerns, obstacles to optimal health, and facilitators for well-being among older Latinos. It includes recommendations for meeting the unmet needs of this population group.

HIV and Aging (American Academy of HIV Medicine – AAHIVM) – This section of the AAHIVM website focuses on issues related to HIV and aging.

 

Selected Reports from AIDS Education and Training Centers (AETCs)

18th Annual Conference on HIV/AIDS & Aging (New England AETC, September 2022) – This webinar covers many issues related to HIV and aging, including long-term survival, primary prevention, PEP, PrEP, transgender health, oral health, mental health, and substance use.

Mental Health and HIV Webinar Series Part 4: Trauma and Stressor-Related Disorders (New England AETC, June 2022) – This webinar provides information about the pervasiveness of trauma among people with HIV and the principles of care necessary to avoid doing harm. The diagnosis and treatment of specific trauma disorders, including PTSD, are also discussed.

Mental Health and HIV Webinar Series Part 3: Anxiety Disorders (New England AETC, May 2022) – This webinar provides information about how to appropriately diagnose and effectively treat the most common anxiety disorders in primary care.

Mental Health and HIV Webinar Series Part 2: Pharmacotherapy for Depression (New England AETC, May 2022) – This webinar provides information about the most commonly prescribed antidepressants, including their impact on the management of HIV. Strategies for adjusting, switching, or augmenting antidepressant medications are also discussed.

Mental Health & HIV Webinar Series Part 1: Addressing Depression in People with HIV (New England AETC, May 2022) – This webinar describes the importance of addressing depression in people with HIV, and evidence-based approaches for diagnosing and treating depressive illnesses. There is also a discussion about how treating depression impacts both mental health and HIV outcomes.

Chemsex: Essentials for Treating the Addictive Fusion of Drugs and Sex (New England AETC, April 2022) – This seminar reviews the clinical presentation and treatment of co-occurring drug use (particularly amphetamines) and sexual behavior. Biopsychosocial risk factors are reviewed, along with the specific impact of various drugs on sexual functioning.

Connect to Cure – A Care Innovation Project (New England AETC, October 2021) – This seminar describes a multidisciplinary team’s experience providing innovative care for people at risk of drug and sex-related harms.

HIV and Aging (New England AETC, November 2021) – This podcast covers: 1) the structure and scope of the Veteran Aging Cohort Study (VACS); 2) recent findings on aging with HIV and HIV prevention during aging; and 3) the relevance of the VACS Index in the prognosis of age-related comorbidities among people with HIV.

17th Annual Conference on HIV & Aging (New England AETC, September 2021) – Topics covered in this webinar include: epidemiological updates on HIV and aging in Massachusetts; HIV updates for the aging population; HIV and structural racism; living with HIV and aging during the COVID-19 pandemic; and screening of a video “Someone You Know and Love,” focusing on people with HIV.

HIV & Aging Considerations as Our Patients Grow Older (Northeast/Caribbean AETC, September 2021) – This webinar focusing on managing HIV care for the aging population.

HIV & Aging: The Greying of the HIV Pandemic (South Central AETC, September 2021) – These training slides include clinical vignettes and data illustrating key points about aging and HIV and identify the impacts of the changing demographics of HIV.

Care of People Aging with HIV: Northeast/Caribbean AETC Toolkit (Northeast/Caribbean AETC, July 2021) – This toolkit is designed for clinicians and other professionals who care for people aging with HIV. It provides links to screening and assessment instruments, along with programs and papers that offer clinically useful materials.

Aging with HIV: Challenges for a ‘New Aging’ (Pacific AETC, July 2021) – This online course covers real-world challenges and solutions for people aging with HIV, how psychosocial barriers affect aging people with HIV, and how to realign existing services for older adults with HIV.

Integrating Geriatric Principles in HIV Clinic Pocket Guide (MidAtlantic AETC, July 2021) – This pocket guide reviews the geriatric 5M principles (mind, mobility, multimorbidity, medications, and matters most), the elements of a welcoming environment for older persons with HIV, and a review of geriatric assessment screening tools.

Meeting at the Crossroads of HIV & Aging (New England AETC, June 2021) – This webinar is from a training that addresses the unique health conditions and social determinants of health for the growing population of long-term survivors with HIV, as well as newly diagnosed persons as they grow older.

 

Selected Recent Reports from CDC’s Morbidity and Mortality Weekly Report

Each of these recent reports includes data on, or some discussion of, HIV testing, prevention, care, or other related health issues for older people.

Clusters of Rapid HIV Transmission Among Gay, Bisexual, and Other Men Who Have Sex with Men – United States, 2018-2021

HIV and Sexually Transmitted Infections Among Persons with Monkeypox – Eight U.S. Jurisdictions, May 17-July 22, 2022

Factors Associated with Use of HIV Prevention and Health Care Among Transgender Women – Seven Urban Areas, 2019-2020

Association Between Social Vulnerability and Rates of HIV Diagnoses Among Black Adults, by Selected Characteristics and Region of Residence – United States, 2018

Vital Signs: HIV Infection, Diagnosis, Treatment, and Prevention Among Gay, Bisexual, and Other Men Who Have Sex with Men – United States, 2010-2019

Racial, Ethnic, and Gender Disparities in Awareness of Preexposure Prophylaxis Among HIV-Negative Heterosexually Active Adults at Increased Risk for HIV Infection – 23 Urban Areas, United States, 2019

HIV Infection and HIV-Associated Behaviors Among Persons Who Inject Drugs – 23 Metropolitan Statistical Areas, United States, 2018

HIV Preexposure Prophylaxis Awareness and Referral to Providers Among Hispanic/Latino Persons – United States, 2019

Increasing Access to HIV Testing Through Direct-to-Consumer HIV Self-Test Distribution – United States, March 31, 2020-March 30, 2021

Care Outcomes Among Black or African American Persons with Diagnosed HIV in Rural, Urban, and Metropolitan Statistical Areas – 42 U.S. Jurisdictions, 2018

 

The contents listed on this page are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, the New England AIDS Education and Training Center.