HIV & Aging: Journal Articles

The Bottom line: In 57 adults with HIV measurements of homocysteine, vitamins and neurocognitve performance were made. There were correlations between elevated homocysteine level and worse performance on verbal fluency and executive function. Low levels of vitamin B12 and D were also associated with poor executive function. Possible neurocognitive impairment and abnormal levels of vitamins and homocysteine may be useful information.

The Bottom line: In a study of 400 older persons with HIV and an average age of 59 years the key predictors of the most frequent comorbidities of elevated cholesterol, hypertension, and depression/anxiety were age and duration of HIV infection. With comorbidity frequencies of 24 % to 60%, treatment of comorbiities in older adults with HIV must be aggressively addressed.

A sample of 100 African-American women living with HIV in Chicago and Birmingham in the period 2013-2015 was recruited for participation in a stigma-reduction intervention. The primary goal of the study was to investigate the relationship between HIV-related stigma and viral suppression. A secondary goal was to determine if depression and nonadherence might play an intermediary role between stigma and viral suppression.

An important issue is how depression and substance use interact with the control of the HIV treatment continuum.  A group of 14,380 persons with HIV were studied to determine how depressive symptoms along with alcohol and other substance use affect the continuum of care in these patients.  Standard statistical procedures were used in the analysis.  In those with no or mild depressive symptoms, heavy alcohol had no association with viral suppression; but, among those with moderate or severe symptoms heavy alcohol use did have a negative effect on viral load.

It is not known how sleep disturbance might contribute to risk of depression in adults with HIV.  The investigators addressed this question by using data from the Multicenter AIDS Cohort Study (MACS), which is a longitudinal study following men who have sex with men (MSM), some with HIV and others without HIV.  Information on self reported sleep problems for greater than two weeks and increased depression symptoms using the CES-D screening tool provided baseline and data every 6 months over 12 years of follow-up.

Depression is found frequently with HIV/AIDS, but the reasons for this association are unclear.  An important question is the possible effect of immunological factors on depression.  In 201 persons with HIV/AIDS being seen in clinics in Uganda a study was mounted to address this issue. Information on depression was collected, and the diagnosis of major depressive disorder (MDD) was based on DSM-IV criteria. The frequency of MDD was 30.8% in this population.

For the 6th consecutive year there has been an almost 35% increase in the number of journal articles that address HIV and Aging issues. Many in the current Annotated Bibliography for 2018 reflect the observation that the older adult with HIV is at markedly increased risk for multimorbidity. Increasingly HIV treating physicians are spending most of their time managing non-HIV conditions.

Many research reports identify cognitive impairment in adults with HIV. Tracing this impairment to HIV infection itself has been elusive. This paper investigates whether physical activity and associated cardiovascular risk may underlie these reported increased rates of cognitive impairment. The study used 988 participants (20% women) with well-controlled HIV infection at entry into the AIDS Clinical Trials Group (ACTG) Protocol A5322 (HAILO). The cardiometabolic risk profiles between women and men with HIV were assessed.

Using a sample of 122 PLWH (People Living With HIV) and 95 HIV negatives, ages 35-65, the study created a composite score that assessed trauma, economic hardship (food insecurity and low socioeconomic status), and a stress composite variable (TES). Study participants also completed a comprehensive neuropsychological battery and an assessment of activities of daily living (ADLs). The PLWH group had more traumatic events, more food insecurity, lower socioeconomic status, and higher perceived stress when compared to the uninfected group (p<0.0001).

During the period of 2004 to 2015 54,102 new HIV diagnoses in older adults (50 years and older) were tabulated from 31 European countries. A larger younger group (15-59 years) was collected for comparison. Also, information on age, sex, transmission route and CD4 count was obtained. During the 12-year study period for the entire group the average rate of new HIV diagnoses increased 2.6 per 100,000 in the population. The diagnoses increased significantly among older men, 2.2%, women, 1.3%, men who have sex with men, 5.8%, and injection drug users, 7.4%.

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Purpose of this Program: The AAHIVM, ACRIA and AGS (collectively, the “Sponsors,” “we” or “us”) are sponsors of this Website and through it seek to address the unique needs and challenges that older adults of diverse populations living with HIV face as they age. However, the information in this Website is not meant to supplant the advice provided in a doctor-patient relationship.

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The American Academy of HIV Medicine is a professional organization that supports the HIV practitioner and promotes accessible, quality care for all Americans living with HIV disease. Our membership of HIV practitioners and credentialed HIV Specialists™, HIV Experts™, and HIV Pharmacists™ provide direct care to the majority of HIV patients in the US.