Aging with HIV: A Growing Issue

Two women sitting at a tableThroughout the 30-year history of HIV, there have been continually changing issues, and one of the newly emerging challenges is the need for specialized care for an aging group of HIV-positive people.

That would have seemed beyond anyone’s wildest dreams in the early years. And while it is certainly a positive, it also means those who provide care for older Americans need to develop programs and policies never thought of in years past.

This year the Leadership Council of Aging Organizations (LCAO), an umbrella group for aging-related organizations throughout the U.S., developed a series of recommendations it hopes will be included into the reauthorization of the Older Americans Act, a primary piece of legislation aimed at providing services to older people.

The LCAO, working in cooperation with the group Services & Advocacy for GLBT Elders (SAGE) and several other specialty groups focused on either the aging or the HIV community, came up with eight recommendations that would provide specific help for gay, lesbian, bisexual and transgender through the Older Americans Act.

Not only are HIV-positive people living into older ages, the Center for Disease Control reports a significant amount of new HIV infections occur among people over age 50. The CDC says about 15 percent of new HIV infections are in the over-50 age group. It estimates that 28 percent of all HIV-positive Americans are over 50. More noteworthy is the estimate that by 2017 half of all HIV-positive Americans will be at least 50.

The recommendations for the Older Americans Act—which will be reauthorized as part of the 2012 federal budget—call for inserting language that would better address the specialized needs of both ethnic minorities and members of the LGBT community.

The needs of HIV-positive older Americans should be addressed in federal research projects, prevention efforts and should become an element in training programs for senior services, according to a statement issued with the recommendations.

“As the backbone of our nation’s support system for older adults, it is essential that a reauthorized Older Americans Act recognizes and addresses the needs of all elders,” Sandra Markwood, the CEO of the National Association of Area Agencies on Aging, said in a statement announcing the recommendations.

The LCAO report and other studies related to the graying HIV community point out there are specific challenges for the HIV infected, many which are social and cultural.

For example, language in the legislation should be adapted to note the unique circumstances of many HIV-infected people from the LGBT community. That would require adjusted legal definitions of family, spouses, family caregivers and even family violence.

The existing OAA includes language that addresses the “vulnerable population” and those with the “greatest social need.” The LCAO recommendations call for new language that would specify the needs of various minorities, including the LGBT community, within those categories.

studies on HIV-positive older Americans point out that they are prone to social isolation, they are more apt to experience depression, poor nutrition, and as a result, premature mortality.

In addition, older Americans, especially from the LGBT community, have a fear of discrimination that makes them less likely to seek timely medical care, leading to more serious and advanced medical problems.

HIV prevention efforts also tend to overlook older Americans, based in part by assumptions they are not sexually active. But those assumptions are offset by the CDC statistics on new HIV infections among older adults.

Finally, because HIV has only been a medical issue for the current generation of older Americans, treatment and services need to be adjusted to a reality that did not exist among previous generations.