Nursing considerations of major clinical issues

Elizabeth Crock: Bolton Clarke HIV Program, Melbourne
Jayne Howard: Victorian HIV Service, Alfred Hospital, Melbourne

Ageing with HIV (See also HIV and Ageing)

As the life expectancy of people with human immunodeficiency virus (HIV) increases due to successful treatment, more people with HIV are ageing. The average age of people with HIV in Australia is over 45 and the number of people over 60 has been increasing at 12% per year since 1995.[1] The proportion of people over 55 years with HIV was 25.7% in 2010, and there is a predicted increase to over 44% by 2020.[2] [3]  

Older people with HIV may be long-term survivors of HIV. However, there are also significant numbers of older people being newly diagnosed with HIV.  Between 2012 and 2014, 17% of new HIV diagnoses in Australia occurred in people 50 years and over.[4]  People diagnosed with HIV when they are over 50 years of age tend to have more advanced disease and experience greater HIV–related illness.[5] Older people who are newly diagnosed and have advanced HIV disease can have very different needs to those who are long-term survivors (see Nursing implications of late diagnosis - severe disease, treatment, and prevention of opportunistic illnesses).

An important question with respect to HIV is the phenomenon of early, premature or accelerated ageing.  It has been observed that people with HIV experience some problems associated with ageing at earlier ages than people who do not have HIV, such as frailty and osteoporosis.  This has been attributed to the effects of the virus, lifestyle risk factors which are over-represented among people with HIV,[6] but also to some antiretroviral medications.[7]