Aging with HIV
More people are living into older age with HIV. Learn about the unique health considerations for older adults with HIV.
More people are living into older age with HIV. Learn about the unique health considerations for older adults with HIV.
Thanks to effective antiretroviral therapy (ART), people with HIV are living longer than ever before. According to the CDC, more than half of people with HIV in the United States are now aged 50 or older. This represents a remarkable success story — but it also brings new health challenges that require attention.
Older adults with HIV may face a "double aging" phenomenon: the normal aging process combined with the effects of long-term HIV infection and decades of antiretroviral therapy. This can lead to earlier onset of age-related conditions such as cardiovascular disease, bone loss, kidney disease, and cognitive changes.
People with HIV have a 50–100% higher risk of cardiovascular disease compared to HIV-negative peers. Regular blood pressure monitoring, lipid testing, and cardiovascular risk assessment are essential. Lifestyle modifications and statins may be recommended.
HIV and some ART medications can reduce bone mineral density, increasing fracture risk. DEXA scans are recommended for older adults with HIV. Calcium and vitamin D supplementation, weight-bearing exercise, and smoking cessation can help protect bone health.
HIV and certain ART medications (particularly tenofovir disoproxil fumarate/TDF) can affect kidney function. Regular monitoring of kidney function (creatinine, eGFR) is important. Switching to tenofovir alafenamide (TAF) may reduce kidney risk.
HIV-associated neurocognitive disorders (HAND) can affect memory, concentration, and executive function. While severe HAND is less common with effective ART, milder cognitive changes may occur. Neuropsychological testing can help identify and monitor cognitive changes.
People with HIV have higher rates of certain cancers, including anal cancer, cervical cancer, and some non-AIDS-defining cancers. Regular cancer screening (colonoscopy, mammography, anal Pap smears, lung cancer screening for smokers) is recommended.
Older adults with HIV often take multiple medications for HIV and other age-related conditions. This polypharmacy increases the risk of drug-drug interactions. Some HIV medications can interact with common medications for heart disease, diabetes, and other conditions. It's important to: