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Forgotten Aging HIV+ - An Explosive
Devastating Problem Being Ignored - its scandalous
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NATAP Dedicated Aging & HIV Section
http://www.natap.org/age.htm
from Jules: it's a scandal that federal officials have done nothing to even begin discussing the services needed by older HIV+ aging ! Industry too owes an obligation to be doing more. A significant portion of older aging HIV+ in the USA are suffering with multiple comorbidities & polypharmacy, for them its devastating - worsening cognitive impairment, bone disease & fractures or risk for fractures, heart disease, cancers, diabetes, kidney disease, depression, isolation, worse stigma & self stigma, inability to perform daily functioning. We need policy makers in HIV to address these issues for patients and their clinicians. These high risk patients & their clinicians need a package of special support services & care, a carve out of services. At this time local HIV/AIDS officials as well as federal officials and RW council members are not addressing these issues. It's as if they are all waiting for this patient group to die off. Federal officials like Fauci & Dieffenbach ignore these problems as if they do not exist. CDC, HRSA, RWCA, HHS, NIH must be responsive to the needs of tis 1st generation of surviving older HIV+, not to do so as is the current status is complete I expect soon mortality rates will increase and many long term survivors will become severely disabled and require long term home care or a facility to be placed in & this need gets absolutely no recognition & attention. We must step up our attention & recognition of this unique problem in HIV, for these individuals the giddiness of the success of ART of the mid 1990s through integrase is long gone. We have come full circle from the early days of 3 drug HAART to now 20 years later where premature aging in HIV is reaping serious problems for many. 80% of HIV+ in the USA are over 40-45 years old, 50% over 50, 25% over 60 and soon 50% will be over 60, and the aging of the HIV population will only evolve more. Industry too must be responsive, they too owe this forgotten community & problem attention & recognition.
Aging of HIV-Infected: a explosive and underestimated phenomena being ignored, needs attention - special support services for patients & clinics needed-lack of federal/state response - HCV too - Commentary by Jules Levin - (04/04/17)
Aging in US - Worse Still To Come - polypharmacy, multiple comorbidities, decreased survival, impaired daily activities functioning -
Psychiatric symptom burden in older people living with HIV with and without cognitive impairment: the UCSF HIV over 60 cohort study - (01/11/18)" In sum, our study evidenced a substantial neurobehavioral burden in a sample of HIV-infected participants aged 60 and older,regardless of cognitive status, compared to historical healthy controls.
Elucidating the impact of neuropsychiatric symptoms on everyday functioning may help inform interventions aimed at reducing the burden for patients, caregivers and healthcare systems.....there was a greater overall symptom burden in HIV compared to healthy elder controls (n = 236, p < 0.05), with more frequent agitation, depression, anxiety, apathy, irritability and nighttime behavior disturbances (p < 0.05). Our findings demonstrate no differences in psychiatric comorbidity by HAND status in older HIV participants; but confirm a substantial neurobehavioral burden in this older HIV-infected population."
HIV & Aging - Mental Needs: Policy, Mental Health Services Program, Comorbidities, Services for Aging/Older HIV+ - (09/29/14)
many research gaps need to be addressed, including a better conceptualization and measurement of successful aging and the development of high-quality integrated care, programs, and services tailored to the needs of older people with HIV. A more integrated policy response is needed to improve the psychosocial and economic well being of older people with HIV. The process of aging may be more challenging for people living with HIV than for the general population. This is because of the detrimental effects that HIV and its treatment have on normal aging processes as well as other factors, such as HIV-related stigma, loss of friends and social networks
healthcare providers, front-line workers, and policy makers should have a greater understanding of the experience of aging with HIV......policy makers......HAND can have damaging effects on older adults' psychosocial well being....uncertainties include concerns regarding the ability of healthcare providers to provide high-quality care at the intersection of aging and HIV; the financial situation and transition to retirement, including adequate pension; the availability of appropriate long-term housing; and the decreasing ability to care for themselves...we need Integration of HIV primary care and mental health....At a minimum, packages of care for selected MNS disorders should be included when scaling-up HIV primary care prevention and treatment services
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