HIV is preventable, although many people living with the human immunodeficiency virus do not know that they have it. HIV is also treatable. This means that more people who are HIV positive are living longer, and living normal, and often healthy lives. Over a quarter of people who are HIV positive in the United States are over the age of 55. [1]

September 18 is National HIV/AIDS and Aging Awareness Day—bringing awareness to this cluster of the population and the unique issues facing HIV positive older adults. While some older adults with HIV have few if any complications, another subset of the population that has been living with the HIV infection for a number of years or decades, may face complications attributed to long-term HIV infection. [1]

What complications are attributed to HIV and aging?

AIDS—Acquired Immune Deficiency Syndrome—is the most well-known but is not the only long-term condition that develops for people with HIV. [1] As people who are HIV positive age they may may face several diseases associated with HIV including, lung disease, liver disease (including hepatitis B and C), heart and lung problems, and neurocognitive disorders, known as HIV-Associated Neurocognitive Disorders [1] , which include asymptomatic problems, mild neurocognitive issues, and moderate-to-severe neurocognitive problems, known as HIV-associated dementia. [2] AIDS-related dementia is now rare, but HIV-associated dementia affects more than half of people who are HIV positive. [1] Certain cancers affect people with HIV more often, including lymphoma

Diagnosis timing has an impact, too

While younger people may have increased opportunities to be screened for HIV, older people may be diagnosed as having HIV late into the infection, when treatment is not as successful. Because many HIV associated problems can look like “normal aging”, it may not lead to a quick diagnosis for older adults—resulting in delayed treatment and progression of the viral load associated with HIV. [1]

HIV is also growing to be less and less stigmatized as years go on and people understand that it cannot be spread through casual contact, and the real origins of the condition. Initial reactions to AIDS in 1982 lead it to be linked only to gay men, which we now know is untrue—this, however, is likely what may have perpetuated and caused stigma for decades to come. [3] In 1983, it was determined that casual contact (touching, food, air, water, surfaces) did not spread AIDS, and in 1984, it was discovered the cause of AIDS was HIV. [3] In 1991, the misappropriation that HIV only affected the gay community was still common, despite more and more stories of well-known celebrities acquiring HIV, as well as of children (as well as adults) acquiring HIV through blood transfusions. [3]

The history of HIV means that people, still, may be reluctant to talk about HIV, and for older adults, this puts them at greater risk of complications from delayed treatment. [1] As younger people may be more routinely screened for HIV, especially if they have risk factors like being sexually active or injection drug use, older people may not be routinely screened—meaning infections can be undetected longer, and a person may be sicker when they are finally diagnosed.

A public health issue

As HIV/AIDS is a public health issue, and the stigma associated with it is an equal problem, educating older adults about HIV, and the impact of HIV and aging is important. While precautions are taken in hospitals to keep everyone safe, if you are HIV positive or have complications of HIV including AIDS, cancers, heart or lung problems, wearing a HIV/AIDS medical ID bracelet can help ensure you get the right treatment if you become ill unexpectedly.