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Aging With HIV
The Silver Tsunami in HIV: An Advocate’s Perspective

Released: November 19, 2024

Expiration: November 18, 2025

Violet Zulu
Violet Zulu,
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Key Takeaways
  • Aging with HIV requires comprehensive care addressing comorbidities, mental health, and social services.
  • To better address the needs of aging individuals living with HIV, patient-centered care must overcome HIV-related stigma and systemic barriers to care.

As an HIV advocate and person living with HIV, I’ve witnessed the complexities of aging with HIV. The recent studies presented at IDWeek 2024 resonated deeply with me and highlighted the need for holistic care. Growing up, I’ve seen how HIV affects entire communities, and now, as I get older, I realize the importance of comprehensive care.

Key Studies From IDWeek and HIV Glasgow 2024
Globally, HIV is often stigmatized, and aging with the condition comes with unique challenges. At IDWeek, Siobahn O’Connor and colleague presented a poster from the Centers for Disease Control and Prevention, which highlighted the alarming statistics of people living with HIV aging in the United States, but similar trends are also seen in Africa. For instance, the largest group of patients with HIV in the United States is now 55 to 59 years old (up from 50-54 years old in 2010). At least 50,000 persons are now 75 years or older with HIV as well. Our healthcare systems must prioritize addressing aging-related comorbidities in HIV. 

Through my work as an HIV advocate and treatment supporter at Partners in Hope, I’ve witnessed the impact of comorbidities on people living with HIV. Many struggle to manage noncommunicable diseases like hypertension, diabetes, and obesity alongside HIV. One study at IDWeek, presented by Grace Lui and colleagues, showed that almost half of patients with HIV have hypertension, over one third have diabetes, and over half have obesity. These comorbidities lead to an increased risk of clinical complications and impaired quality of life. This firsthand experience has deepened my commitment to advocating for comprehensive care for those aging with HIV.

One study from Duke University, presented by Alice Schaack and colleagues, emphasized the importance of accessible prevention strategies. The study showed that despite the clear desire for long-acting injectable pre-exposure prophylaxis (PrEP), people are rarely offered this preventive treatment and awareness continues to be low. As someone who has  benefited from using PrEP, I urge policymakers and healthcare professionals to prioritize awareness and availability of long-acting injectable PrEP options. As someone living with HIV, I take an active role in promoting HIV prevention and awareness in my personal life as well. In fact, I initiated the idea for my partner (boyfriend) to access injectable cabotegravir, a groundbreaking PrEP treatment. I have been an integral part of his treatment journey. I accompany him to his appointments, providing emotional support and ensuring he stays adherent to the treatment regimen. Seeing him take proactive steps to protect his health has significantly reduced my anxiety about transmission, allowing us to navigate our relationship with greater ease and peace of mind. Our open and honest discussions about HIV prevention, treatment, and adherence have fostered a deeper understanding and connection. Together, we’re committed to advocating for HIV education, support, and inclusivity.

Overcoming HIV Stigma and Barriers
Breaking down systemic barriers and reducing HIV stigma is crucial. Globally, culture and socioeconomic factors often hinder access to HIV care. As advocates, we must push for patient-centered care that addresses the unique needs of aging in people living with HIV. 

Aging with HIV requires comprehensive, patient-centered care, underpinned by robust health economics. We must prioritize holistic care, accessible prevention strategies, HIV stigma reduction, and systemic barrier elimination. Furthermore, sustainable funding for HIV research, treatment, and prevention programs is critical. Health economics plays a vital role in allocating resources efficiently, ensuring cost-effectiveness, and maximizing impact. By acknowledging the complexities of aging with HIV and investing in evidence-based solutions, we can ensure that people living with HIV receive the care they deserve.

To achieve this vision, healthcare professionals, governments, communities, and advocates must work together to integrate comprehensive care, increase funding for HIV research, reduce stigma, and amplify the voices of aging people living with HIV. By implementing these characteristics, the lives of aging people living with HIV can improve globally. Sustainable change requires collective action, and I urge everyone to take responsibility for creating a better future for those aging with HIV.

Your Thoughts?
How do you best care for aging people living with HIV? Get involved in the discussion by posting a comment below!