HIV infection in the elderly

University of the Pacific School of Pharmacy and Health Sciences, Stockton, CA, USA.
Clinical Interventions in Aging (Impact Factor: 2.08). 02/2008; 3(3):453-72.
Source: PubMed

ABSTRACT In the US, an estimated 1 million people are infected with HIV, although one-third of this population are unaware of their diagnosis. While HIV infection is commonly thought to affect younger adults, there are an increasing number of patients over 50 years of age living with the condition. UNAIDS and WHO estimate that of the 40 million people living with HIV/AIDS in the world, approximately 2.8 million are 50 years and older. With the introduction of highly active antiretroviral therapy (HAART) in the mid-1990s, survival following HIV diagnosis has risen dramatically and HIV infection has evolved from an acute disease process to being managed as a chronic medical condition. As treated HIV-infected patients live longer and the number of new HIV diagnoses in older patients rise, clinicians need to be aware of these trends and become familiar with the management of HIV infection in the older patient. This article is intended for the general clinician, including geriatricians, and will review epidemiologic data and HIV treatment as well as provide a discussion on medical management issues affecting the older HIV-infected patient.

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    • "Participants were divided into three separate groups based upon age: young adulthood (#35 years), middle adulthood (36–50 years), and older adulthood ($51 years). We based this categorization on both Erikson's stages of human development and the CDC's historical classification of PLWH over age 50 years as elderly (the average age of PLWH is approximately 30 years; CDC, 2008; Erikson, 1964; Nguyen & Holodniy, 2008). One hundred two eligible participants completed the study procedures. "
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    ABSTRACT: People living with HIV (PLWH) are living longer and are at greater risk for chronic comorbidities (e.g., cardiovascular disease, cancer) compared to those not living with HIV. Regular, sustained exercise can prevent and/or mitigate the severity of these comorbidities. Our purpose was to describe patterns of planned exercise implemented in the home setting (i.e., free-living exercise) in PLWH by gender and age. PLWH (n = 102) completed a sociodemographic survey and a 7-day exercise diary documenting daily exercise duration, frequency, and intensity. Women exercised an average of 2.4 (IQR: 0.5, 6.0) hours per week compared to men who exercised 3.5 (IQR: 0.5, 7.5) hours per week (p = 0.18). This relationship was particularly evident during middle adulthood for women versus for men (p = 0.05). PLWH exercised regularly but at less than recommended levels. This is among the first evidence describing free-living exercise patterns of PLWH.
    Journal of the Association of Nurses in AIDS Care 07/2014; 26(2). DOI:10.1016/j.jana.2014.06.004 · 1.27 Impact Factor
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    • "In addition to the challenge of providing financial support to their households, given the high HIV burden in South Africa, older persons are also providing long-term personal and health care to their adult offspring infected with HIV and to younger children upon the death of their parents [28-34]. Furthermore, older people are at risk of becoming HIV-infected themselves [35-37], with additional numbers coming from HIV-infected adults on treatment living longer [38]. It is thus important to study the socio-economic and demographic factors influencing the health status of older people in rural South Africa. "
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    ABSTRACT: Despite the severe impact of HIV in sub-Saharan Africa, the health of older people aged 50+ is often overlooked owing to the dearth of data on the direct and indirect effects of HIV on older people's health status and well-being. The aim of this study was to examine correlates of health and well-being of HIV-infected older people relative to HIV-affected people in rural South Africa, defined as participants with an HIV-infected or death of an adult child due to HIV-related cause. Data were collected within the Africa Centre surveillance area using instruments adapted from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE). A stratified random sample of 422 people aged 50+ participated. We compared the health correlates of HIV-infected to HIV-affected participants using ordered logistic regressions. Health status was measured using three instruments: disability index, quality of life and composite health score. Median age of the sample was 60 years (range 50-94). Women HIV-infected (aOR 0.15, 95% confidence interval (CI) 0.08-0.29) and HIV-affected (aOR 0.20, 95% CI 0.08-0.50), were significantly less likely than men to be in good functional ability. Women's adjusted odds of being in good overall health state were similarly lower than men's; while income and household wealth status were stronger correlates of quality of life. HIV-infected participants reported better functional ability, quality of life and overall health state than HIV-affected participants. The enhanced healthcare received as part of anti-retroviral treatment as well as the considerable resources devoted to HIV care appear to benefit the overall well-being of HIV-infected older people; whereas similar resources have not been devoted to the general health needs of HIV uninfected older people. Given increasing numbers of older people, policy and programme interventions are urgently needed to holistically meet the health and well-being needs of older people beyond the HIV-related care system.
    BMC Public Health 04/2012; 12(1):259. DOI:10.1186/1471-2458-12-259 · 2.26 Impact Factor
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    • "Over 6% of men and 9% of women age 60 years and older with no medical history of sexually transmitted infections (STI) at the time of death were found to be HIV-seropositive (El-Sadr & Gettler, 1995). In fact, it is even more common for older women to die within a month of being diagnosed with AIDS because of the advanced stage of illness (Lekas, Schrimshaw, & Siegel, 2005; Mack & Bland, 1999; Nguyen & Holodniy, 2008). Given these rates of infection and abrupt mortality, it is critical that we develop a better understanding of what impacts the VCT patterns of this population. "
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    ABSTRACT: The rate of cases of HIV/AIDS in older people is increasing; indeed one out of every four people with HIV/AIDS is over age 50. This study describes the correlates of HIV Voluntary Counseling and Testing (VCT) using structural equation modeling techniques for a sample of 135 middle-aged and middle-aged and older Latinas in South Florida. Over 60% of participants had been tested for HIV. Provider endorsement was found to be the strongest predictor of VCT (odds ratio [OR] = 6. 38), followed by having a clinic as a regular source of healthcare (OR = 3.88). Social work implications are provided.
    Journal of Women & Aging 04/2012; 24(2):97-112. DOI:10.1080/08952841.2012.639650 · 0.58 Impact Factor
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