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Bone Mineral Density in a Cohort of Young Adult Women using Depo-provera and Tenofovir, Kampala, Uganda
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from Jules: Aging with HIV is fast becoming a crisis & epidemic in the US and other Western regions because we know that older aging HIV+ (over 50 & over 60) are experiencing high rates of polypharmacy (8-15 medications daily), multiple comorbidities (3-6 comorbid conditions), PLUS depression, isolation, increased stigma & self-stigma, increasing frailty & disability, increasingly worsening mobility and impaired gait PLUS cognitive & neurologic impairment, bone disease and multiple fractures, and heart disease is 50% greater in prevalence in HIV+ compared to HIV-negatives; PLUS increased diabetes particularly in older HIV+ compared to both younger HIV+ and HIV-negatives; PLUS cancers, certain types of cancers are affecting many older HIV+.
Local city government research shows 80% with HIV in the USA are already over 45 years old in certain major cities including LA, NY, Boston, SF, Florida - with 50% over 50, and 25% over 65; its estimated as well that by very soon 50% will be over 60. The HIV population is quickly aging BUT not just in the USA and other developed Western regions including Western Europe and Australia, BUT also in less developed areas. Its understood that in recent years the great concern was to get ARTs and screening to these less developed areas. BUT we must NOT overlook this aging problem in Africa, India, China, Russia etc. Even in the USA the HIV healthcare infrastructure is NOT prepared to properly address these problems. The federal government officials have essentially ignored this problem and in some cases are not even aware of the problem. In some cases key top officials know of the problem to some degree but have put it on the back burner. We do NOT have any time to waste or delay addressing these problems. What will we do to house completely disabled HIV, long term institutionalized housing & care for these HIV+ has not been on anyone's radar. There are 2 recently opened Aging Geriatric Clinics in the US, in SF at SFGeneral Hospital & at Cornell HIV clinic in NYC. But these are nw programs and just finding their way, and they are the only 2 programs of this type. In London I understand there are a few similar clines and in Italy Giovanni Guaraldi has a unique clinic. BUT there is NO wide discussion of this problem either in the USA or globally. WHO, IAS, MSF and other global leaders MUST begin to discuss this problem. We need a National Discussion on Aging in the USA and a Global Discussion on HIV & Aging at IAS and at WHO, and many venues throughout the globe.
Reported by Jules Levin
19th International Workshop on Adverse Drug Reactions and Co-Morbidities in HIV, 24 October 2017
Flavia Matovu Kiweewa, Noah Kiwanuka, Delia Scholes, Esther Isingel, Mary Glenn Fowler, Clemensia Nakabiito, Monica L. Nolan, Philippa Musoke, John M. Pettifor, Todd Brown, Mags Beksinska
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