Today, people living with HIV receiving treatment can expect a near normal lifespan – something 20 years ago sounded impossible! With the focus now on maximising longevity and quality of life, growing old and navigating all that the ageing process entails is now a reality for many HIV-positive people.
Ageing with HIV presents a number of unexpected challenges for the person living with the virus as well as those who provide care. Studies suggest people living with HIV as they age are susceptible to high rates of cardiovascular disease, cancer, chronic kidney disease, diabetes, osteoporosis, frailty, and neurocognitive deficits. This phenomenon is often described as premature ageing or accelerated ageing.
Research is underway to understand this phenomenon of premature ageing in people with HIV – studies are looking at the effects of long-term antiretroviral therapy; effects of long-term HIV infection; physical effects of ageing and the interaction of the virus; and the effects of long-term behaviours.
Although anti-retrovirals are much less toxic today than previously, it is becoming evident that long-term antiretroviral treatment may increase the risk of a person developing certain health conditions. In addition, the virus itself is believed to also have an effect on certain health conditions associated with ageing. Certain behaviours like smoking, drinking and a lack of exercise also have an impact and with people with HIV now living long enough, behaviour-related health conditions are more likely to develop.
In addition to the health issues experienced by the ageing population as a whole, women living with HIV face some specific challenges as they age. There is a growing body of evidence that suggests that women living with HIV have an earlier onset of menopause, an increased risk of cardiovascular disease, high blood cholesterol levels, diabetes and osteopenia and osteoporosis, and increased risk of non-AIDS defining cancers.
There are also emotional, psychological and psychiatric challenges of ageing with HIV such as neurocognitive disorders, depression and anxiety, and family and parenting issues.
People living with HIV face may potentially face physical and emotional health issues as they age. However, with the appropriate interventions, lifestyle choices and integrated support from health care professionals and community groups, the impact of these challenges can be effectively managed.