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. 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, 2019:
- The percentage of RWHAP clients aged 55 and older increased from 16.6% in 2010 to 32.8% in 2019.
- Viral suppression rates among clients receiving RWHAP medical care were higher than the RWHAP average of 88.1%: 92.4% for RWHAP clients 55-64 and 95.4% for those 65 and older.
I Am a Long-term Survivor of HIV (HIV.gov blog)
Aging Trend Likely to Continue
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
In 2020, HRSA's HIV/AIDS Bureau released two Optimizing HIV Care for People Aging with HIV reference guides. Incorporating New Elements of Care presents a demographic summary 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.
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.
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.