The population of people with HIV in the United States is, on average, growing older. This is a sign of success that has been underway since the 1990s as people with HIV are increasingly engaged in care and benefiting from effective treatments.
These trends are reflected in HRSA's Ryan White HIV/AIDS Program (RWHAP) client level data. According to the RWHAP Annual Client-Level Data Report, 2020 (HRSA, 2021):
- The percentage of RWHAP clients aged 55 and older increased from 16.6% in 2010 to 34.6% in 2020.
- Viral suppression rates among clients receiving RWHAP medical care were 93.0% for RWHAP clients 55-64 and 95.7% for those 65 and older. Both rates are higher than the RWHAP average of 89.4%.
By 2030, 64% of RWHAP clients are projected to be 50+ (Projected Growth and Needs of Aging People Living with HIV in HRSA’s Ryan White HIV/AIDS Program, CROI 2019 poster 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 HIV/AIDS Bureau and its supported programs have released multiple resources in recent years that focus on the specific HIV care needs of older individuals.
Health Coverage and Medicare
As the HIV population ages, Medicare, the 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 Medicare Coverage a collection.
Optimizing HIV Care for People Aging with HIV
These reference guides include:
- Incorporating New Elements of Care provides a summary of demographics on the increasing proportion of people with HIV in the U.S. who are over 50; common health challenges; gaps in medical management and tools to assess older patients; and social challenges often faced by older persons like social isolation.
- Putting Together the Best Health Care Team reviews the roles of the care team (e.g., nurses, case managers, pharmacists); staff training to provide, including how to conduct various patient assessments; and what to cover in undertaking an organizational assessment of a clinic's capacity to deliver care to its older patients.
Both resource guides provide links to tools for the care team, including the AETC's Care of People Aging with HIV Toolkit and the HIV in Older Adults Key Populations sub-section in the National HIV Curriculum.
Recommendations for Improving Care
In 2021, HRSA HAB released input from a Technical Expert Panel, Addressing the Health Care and Social Support Needs of People Aging with HIV, summarizing considerations and ideas for improving HIV care for older individuals.
I Am a Long-term Survivor of HIV (HIV.gov blog)
Focus on Health and Support Needs
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.
The Ryan White Clinical Conference has included multiple sessions on the clinical care needs of older individuals with HIV. At the 2021 Ryan White Clinical Conference were a general session on Managing Aging and HIV (recording and slides) and a breakout session, Managing the Care of Older Patients With HIV.