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Global and regional trends of people living with HIV aged 50 and over: Estimates and projections for 2000-2020
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PLHIV50+ have a greater burden of co-morbidities and treatment side effects compared with younger PLHIV.
PLHIV and other key population groups are marginalized, stigmatized and discriminated against, and face a range of health and social challenges [52,53]. PLHIV50+ are more likely to be single, live alone, have fewer friends and lack adequate social support networks compared to younger PLHIV [54,55]
The proportion of PLHIV50+ around the world increased substantially from 8% in 2000 to 16% in 2016 and is expected to reach an estimated 21% by 2020. In 2016, 80% of PLHIV50+ lived in LMICs and this percentage is expected to continue to increase. Eastern and Southern Africa is home to the largest number of PLHIV50+, however, all regions around the world have substantial numbers of PLHIV50+ and all are likely to increase by 2020.
As PLHIV age, the likelihood of them developing Noncommunicable diseases (NCDs) increases and their overall burden of NCDs will increase in the future. A recent study projected that by 2030, 84% of Dutch PLHIV will be suffering from at least one NCD in addition to HIV [16]. The underlying pathophysiological cause is chronic inflammation by chronic immune activation. PLHIV have higher markers of inflammation [35] and HIV treatment failure increases with increased inflammation [36]. The process of chronic inflammation is further accentuated by other chronic diseases, as well as socio-economic and behavioural factors [37].
Abstract
Background
The increasing numbers of people living with HIV (PLHIV) who are receiving antiretroviral therapy (ART) have near normal life-expectancy, resulting in more people living with HIV over the age of 50 years (PLHIV50+). Estimates of the number of PLHIV50+ are needed for the development of tailored therapeutic and prevention interventions at country, regional and global level.
Methods
The AIDS Impact Module of the Spectrum software was used to compute the numbers of PLHIV, new infections, and AIDS-related deaths for PLHIV50+ for the years 2000-2016. Projections until 2020 were calculated based on an assumed ART scale-up to 81% coverage by 2020, consistent with the UNAIDS 90-90-90 treatment targets.
Results
Globally, there were 5.7 million [4.7 million- 6.6 million] PLHIV50+ in 2016.
The proportion of PLHIV50+ increased substantially from 8% in 2000 to 16% in 2016 and is expected to increase to 21% by 2020.
In 2016, 80% of PLHIV50+ lived in low- and middle-income countries (LMICs), with Eastern and Southern Africa containing the largest number of PLHIV50+.
While the proportion of PLHIV50+ was greater in high income countries, LMICs have higher numbers of PLHIV50+ that are expected to continue to increase by 2020.
Conclusions
The number of PLHIV50+ has increased dramatically since 2000 and this is expected to continue by 2020, especially in LMICs.
HIV prevention campaigns, testing and treatment programs should also focus on the specific needs of PLHIV50+.
Integrated health and social services should be developed to cater for the changing physical, psychological and social needs of PLHIV50+, many of whom will need to use HIV and non-HIV services.
Number of people living with HIV who are aged 50 years and older, by region, 2016.
Number of people living with HIV who are aged 50 years and older, high-income countries, and low- and middle-income countries, 2000-2020. the actual number is higher in low and middle incline countries...
Proportion of people living with HIV who are aged 50 years and older, by region, 2000-2020. While proportion is higher in Western, european high income countries…..
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