Due to the success of modern ART and an increase in the average age of new HIV diagnoses, the population of Canadians living with HIV is aging. Over 50% of Canadians living with HIV are now over the age of 50.1 In 2017, 23% of new HIV diagnoses in Canada were in people aged 50 years or older.2 People aging with HIV are living with age-related chronic health conditions (e.g., metabolic syndrome and cardiovascular disease), syndromes of aging (e.g., dementia and frailty) and side effects related to ART.3 In addition, non-ART polypharmacy is common among people aging with HIV and is associated with increasing risk of hospitalization and mortality.3 Disability issues experienced by those aging with HIV also include: uncertainty and worry about aging with a complex chronic disease, mental health challenges, pain, and stigma.4 Therefore, rehabilitation goals that are client-centered and that positively influence physical health and social participation may provide the most meaningful outcomes.5
Evidence-informed resources that address strategies for rehabilitation in those aging with HIV can be found at these links:
- Siegler EL. Recognizing and Addressing Effects of Aging in Older Patients With HIV Clinical Guidelines Program.
- ClinicalInfo.HIV.GOV. HIV and the Older Person.
- American Academy of HIV Medicine, American Geriatrics Society, AIDS Community Research Initiative of America. Recommended Treatment Strategies for Clinicians Managing Older Patients with HIV
- National Resource Center on HIV & Aging (USA). National Resource Center on HIV & Aging.
- Montoya JL, Jankowski CM, O’Brien KK, Webel AR, Oursler KK, Henry BL, Moore DJ, Erlandson KM. Evidence-informed practical recommendations for increasing physical activity among persons living with HIV. AIDS. 2019 May 1;33(6):931-939. doi: 10.1097/QAD.0000000000002137. PMID: 30946147
- Kietrys D, Myezwa H, Galantino ML, Parrott JS, Davis T, Levin T, O’Brien K, Hanass-Hancock J. Functional Limitations and Disability in Persons Living with HIV in South Africa and United States: Similarities and Differences. J Int Assoc Provid AIDS Care. 2019 Jan-Dec;18:2325958219850558. doi: 10.1177/2325958219850558. PMID: 31109225
1 CIHR Canadian HIV Trials Network. HIV, Aging and the CTN.
2 McMillan JM, Rubin LH, Gill MJ. HIV diagnosed after 50 years of age. CMAJ. 2020 Mar 9;192(10):E255. doi: 10.1503/cmaj.191677. PMID: 32152053
3 Montoya JL, Jankowski CM, O’Brien KK, Webel AR, Oursler KK, Henry BL, Moore DJ, Erlandson KM. Evidence-informed practical recommendations for increasing physical activity among persons living with HIV. AIDS. 2019 May 1;33(6):931-939. doi: 10.1097/QAD.0000000000002137. PMID: 30946147
4 O’Brien KK, Brown DA, Corbett C, Flanagan N, Solomon P, Vera JH, Aubry R, Harding R. AIDSImpact special issue – broadening the lens: recommendations from rehabilitation in chronic disease to advance healthy ageing with HIV. AIDS Care. 2020 May;32(sup2):65-73. doi: 10.1080/09540121.2020.1739203. Epub 2020 Mar 24. PMID: 32208741.
5 Galantino ML, Kietrys D. Aging gracefully with HIV disease: Optimizing wellness through models of care. Rehabilitation Oncology 2019:37;3-4.