We can’t talk about HIV without talking about sex, and when it comes to talking about HIV and sex and older adults…often times, mum’s the word. If doctors leave it to older adults to ask about their sexual health, and older adults leave it to their doctors to raise the issue, we have an unmet need. Driving this silence is the fact that older adults are seen as being “too old for sex.” But what does that mean? Sex, sexuality, and sexual health are multi-faceted and much more than insertive sex. Before one can start a conversation about sex, we need to know what we are talking about and how to talk about it. Let’s start with a few definitions.
A major international randomized clinical trial has found that HIV-infected individuals have a considerably lower risk of developing AIDS or other serious illnesses if they start taking antiretroviral drugs sooner, when their CD4+ T-cell count—a key measure of immune system health—is higher, instead of waiting until the CD4+ cell count drops to lower levels. Together with data from previous studies showing that antiretroviral treatment reduced the risk of HIV transmission to uninfected sexual partners, these findings support offering treatment to everyone with HIV.
HIV-infected people have higher risk of many cancers compared to HIV-uninfected people, but it is unclear if the magnitude of this elevated risk is consistent across age groups. As the proportion of HIV-infected people over age 65 is increasing over time and the elderly population is known to have high cancer risk, it is important to understand the relationship between HIV and cancer in this age group.
This important study uses the Veterans Administration database and looks at three important diseases seen in older patients infected with HIV: myocardial infarction, chronic kidney disease, and non-AIDS defining cancers in both infected and uninfected veterans. Almost 100,000 patient charts were evaluated.
Aging with HIV infection is a new, world-wide, phenomenon and investigators are only beginning to understand its implications for clinical care and for our understanding of aging more generally. A collection in the July 2014 issue of Current Opinions in HIV AIDS summarizes what is understood and topics of ongoing investigation. An introductory editorial, written by Drs. Amy Justice and Julian Falutz, suggest that this phenomenon provides a largely untapped opportunity for scientific discovery and clinical insight, emphasizing that for most people aging with HIV infection, life expectancy is not yet “normal” and the experience of aging with HIV infection is not just like that of aging without HIV infection.
The Aging Well with HIV Manual is for people aging with chronic HIV. It describes common health problems that come with chronic HIV infection. Since many of these problems cannot be cured at present, the manual focuses on how to manage them, so that you can age well despite them.
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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.