By Maggie Chartier, PsyD and Monica Rivera Mindt, PhD (Members, APA Committee on Psychology and AIDS)

By 2015, an estimated one out of every two people living with HIV in the United States will be over 50. In fact, the Centers for Disease Control (CDC, 2012) estimated that the number of people living with HIV over 50 was greater than the number under 34 years of age. While 50 may not seem “old” to most of us, many studies have found that age cutoff to be clinically significant. The “graying” of HIV raises important questions for the care and management of HIV through the aging process.

Here are 9 important things to know about HIV and aging:

Older adults have sex and are at risk for HIV!

21-22% of new HIV infections are in people over the age of 50.

Testing is still important in older adults.

Adults with HIV are 5 times more likely to experience depression compared to HIV-negative adults and may be at risk of suicide.

Depression can impair quality of life, daily functioning, engagement in healthcare, one’s likelihood to take their medications as prescribed, and has been associated with a greater number of comorbid health conditions.

HIV-infected older adults are less likely to seek treatment for psychological disorders. We need mental health services for HIV+ older adults that are age-appropriate and reduce symptoms (e.g., depression, anxiety) for the long term.

Adherence to medication in HIV+ older adults may be challenged by many factors including depression, poor social support, and cognitive impairment.

HIV+ adults often have other medical problems in addition to HIV, such as cardiovascular disease, cancer, chronic pain, and osteoarthritis.

When compared to younger HIV-positive adults, older adults often have worse immunological functioning and lower likelihood of survival after an AIDS diagnosis. Adherence can be complicated by the taking of multiple medications and treatments for other medical problems.

Engagement in HIV health care is critical.

HIV stigma and ageism can have a profound impact on health outcomes, medication adherence, difficulty in disclosing HIV status, and an increase in negative psychological states. Increased social support and a sense of control over one’s own life circumstances can help lessen the negative impact of stigma.

Memory and other cognitive challenges often occur in the process of aging and this can be compounded by having HIV. Older adults with HIV who are racial/ethnic minorities may be at particularly high risk.

References & Additional Resources:

APA Office on AIDS

Aging and HIV: How Can Psychology Better Serve the AIDS Generation?

American Academy of HIV Medicine: HIV Specialist – Special Issue on HIV and Mental Health

Behavioral Medicine: Special Issue of Biopsychosocial Aspects of HIV and Aging

Psychology and AIDS Exchange Newsletter: HIV & Aging

Biographies:

Maggie Chartier, PsyD, MPH is the National Public Health Clinical Psychologist for the Department of Veterans Affairs, HIV, Hepatitis, and Public Health Pathogens Program in the Office of Public Health/Clinical Public Health and a Clinical Psychologist at the San Francisco VA Medical Center. She is currently a member of the APA’s Committee on Psychology and AIDS since January 2014.

Monica Rivera Mindt, PhD is at the Department of Psychology, Fordham University, Department of Neurology, Icahn School of Medicine at Mount Sinai, and Department of Psychiatry, Icahn School of Medicine at Mount Sinai. She is currently a member of the APA’s Committee on Psychology and AIDS.