The HIV population in the United States is aging. This is a sign of success as people with HIV are living longer because they are engaged in care and benefiting from effective treatments.
Consider these data from the HRSA Ryan White HIV/AIDS Program (RWHAP) fact sheet, Older Adult Clients: Ryan White HIV/AIDS Program, 2018 (January 2020):
- 46.1% of individuals getting RWHAP care are over 50 years old, similar to the age demographics of all Americans diagnosed with HIV
- 91.5% of those aged over 50 (and receiving RWHAP medical care) are virally suppressed, exceeding the RWHAP average of 87%.
The aging trend has been underway for many years and is projected to continue. In 2018, RWHAP clients aged 55 and older accounted for 31% of all clients, up significantly from 16.6% in 2010. A large proportion of RWHAP clients (45-54 years old) are on the cusp of joining the 55+ age group.
The trend is likely to continue. By 2030, 64% of RWHAP clients are projected to be 50+. See the CROI 2019 poster Projected Growth and Needs of Aging People Living with HIV in HRSA’s Ryan White HIV/AIDS Program, presented by HRSA staff and summarized in the HIV.gov blog HRSA Analyzes Growing Ryan White Client Population Over 50 Years Old.
Care Needs of Older Persons with HIV
HRSA's Reference Guides for Optimizing Care for People Aging with HIV present considerations for health professionals in adjusting operations for older client populations. The first, Incorporating New Elements of Care, reviews common health and social issues for people aging with HIV and the role of screenings and assessments to identify these needs. The other guide, Putting Together the Best Health Care Team, outlines the various role of health care team members.
HRSA also convened two webinars in 2020 to review the HIV care and treatment needs of older persons with HIV. Healthcare Needs of Adults with HIV who are Aging in the RWHAP reviewed medical and support service needs and emerging models of care. Psychosocial and Support Needs for People with HIV who are Aging in the Ryan White HIV/AIDS Program examined such issues as the impact of isolation and stigma.
Health Coverage and Medicare
As the HIV population ages, Medicare, federal health insurance for older Americans, is taking on a larger role. HRSA's ACE TA Center has developed a number of tools to help RWHAP programs navigate Medicare coverage. See the collection in The Basics of Medicare for Ryan White HIV/AIDS Program Clients.
Clinical Insights: HIV Care for Older Persons with HIV
The Ryan White Clinical Conference has included multiple sessions on the clinical care needs of older individuals with HIV. At the 2020 Ryan White Clinical Conference were two sessions: a plenary lecture, Managing Comorbidities in Older Adults with HIV Infection (August 10) and a breakout session, Screening and Management Issues in Older People With HIV Infection.