Published at AIDSinfo here. View a printable version here. (Last updated 4/5/2016; last reviewed 4/5/2016)

Key Points

• In 2012, people aged 55 and older accounted for one-quarter of all people living with HIV infection in the United States.
• Many HIV risk factors are the same for adults of any age, but older people are less likely to get tested for HIV.
• Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone with HIV. Life-long treatment with HIV medicines helps people with HIV live longer, healthier lives.
• Many older adults have conditions such as heart disease or diabetes that can complicate HIV treatment.

Does HIV affect older adults?

Yes, anyone—including older adults—can get HIV. According to the Centers for Disease Control and Prevention (CDC), about one-quarter of all Americans living with HIV in 2012 were 55 years of age and older. The population of older adults living with HIV is increasing for the following reasons:

• Many people infected with HIV at a younger age are growing older. Life-long treatment with HIV medicines (called antiretroviral therapy or ART) is helping these people live longer, healthier lives.
• Thousands of older people become infected with HIV every year.

For these reasons, the population of people living with HIV will increasingly include adults over 60.

Are the risk factors for HIV the same for older adults?

Many risk factors for HIV are the same for adults of any age. But like many younger people, older adults may not be aware of their HIV risk factors. The following are the most common ways that HIV is spread:

• Having sex without using a condom with someone who is HIV positive or whose HIV status you don’t know
• Injecting drugs and sharing needles, syringes, or other drug equipment with others

Some age-related factors also put older adults at risk for HIV infection. For example, older adults who begin dating again after a divorce or the death of a partner may be unaware of the risk of HIV and not use condoms.

Age-related thinning and dryness of the vagina may increase the risk of HIV infection in older women. In addition, women who are no longer concerned about pregnancy may not use a female condom or ask their partners to use a male condom during sex.

Talk to your health care provider about your risk of HIV infection and ways to reduce your risk.

Should older adults get tested for HIV?

CDC recommends that everyone 13 to 64 years old get tested for HIV at least once and that people at high risk of infection get tested more often. HIV testing may also be recommended for adults over 64 who are at risk of HIV infection. For several reasons, older people are less likely to get tested for HIV:

• Health care providers may not think to ask older adults about their HIV risk factors, including sexual activity, and may not recommend HIV testing.
• Some older people may be embarrassed to discuss HIV testing with their health care providers.
• In older adults, signs of HIV infection may be mistaken for symptoms of aging or of age-related conditions. Consequently, HIV testing is often not offered to older adults.

For these reasons, HIV is more likely to be diagnosed at an advanced stage in many older adults. When diagnosed late, HIV is more likely to advance to AIDS.

Ask your health care provider whether HIV testing is right for you. Use these questions from healthfinder.gov to start the conversation: HIV Testing: questions for the doctor.

Is HIV treatment the same for older adults?

Treatment with HIV medicines is recommended for everyone with HIV, and HIV treatment recommendations are the same for older and younger adults. However, age-related factors can complicate HIV treatment in older adults.

• Liver and kidney function decline with age. This decline may make it harder for the body to process HIV medicines and increase the risk of side effects.
• Older adults with HIV may have other conditions, for example, diabetes and heart disease. In addition, HIV may affect the aging process and increase the risk of age-related conditions such as dementia and some cancers. Taking HIV medicines and medicines for other conditions at the same time may increase the risk of drug-drug interactions and side effects.
• Once ART is started, the immune system may not recover as well or as quickly in older adults as it does in younger people.

Despite these age-related factors, some studies show that medication adherence—taking HIV medicines every day and exactly as prescribed—is greater among older adults.

Where can I find more information about HIV and aging?

Click on the links below to find more information about HIV and aging. This fact sheet is based on information from these sources:

From CDC:
HIV Among People Aged 50 and Over

From the Department of Health and Human Services:
Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents: HIV and the Older Patient

From the National Institute on Aging:
HIV, AIDS, and Older People