In this 2020 publication the authors identify certain current general antiretroviral therapy (ART) recommendations for use specifically in older adults with HIV. Included are multiple data driven recommendations that can, if used, result in reduced ART toxicities that are associated with elevated frequencies of various diseases and conditions in HIV + older adults.
This report explores the usefulness of the Veterans Aging Cohort Study (VACS) index in identifying those at risk for low bone mineral density (BMD). In 195 HIV-infected individuals 109 (56%) had low BMD. As the VACS index increased in these individuals, the odds of low BMD became higher.
Among a selected sample of 118 older Black women with HIV almost 90% had moderate to severe depression. This study assessed the contribution of social determinants at intrapersonal, interpersonal, and community levels.
A large study of about 20,000 individuals with HIV including women, men who have sex with women, and men who have sex with men (MSM) was done over 5 years. The goal was to assess the contribution of gender, age, and sexual orientation on person-time spent in: retention in care, ART use, and viral suppression.
An ongoing study of men 50-75 years of age with HIV (279) or at risk for HIV (379) found that about 40% suffered one or more falls over a 2-year period. In both groups with two or more falls, illicit drug use, taking diabetes medications or depression medications, and peripheral neuropathy were the most frequent risk factors.
A total of 782 gay couples, median age 40 years, with one partner HIV positive and the other negative were followed for 3 years. There were 76,000 episodes of anal intercourse without condoms. The investigators reported no episodes of HIV transmission from the positive to the negative partner.
In a cohort of 2,308 persons, mean age 60, hospitalized for heart failure, there were 374 with HIV. On follow-up for short-term readmission and longer-term cardiovascular mortality, the adults with HIV had significantly higher readmissions as well as greater cardiovascular and all-cause mortality rates compared to the HIV-negative group.
HIV is associated with an increased risk of stroke from both the effect of the virus and known risk factors. It appears that traditional risk factors, such as hypertension and smoking, may be even more elevated as risk factors.
Smoking cessation and blood pressure control are recommended for prevention and use of statins is suggested, pending the result of an ongoing clinical trial. Cardiovascular disease is a major comorbidity in older adults with HIV and demands attention.
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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