Many older people with HIV have complex physical health needs

As we discussed in topic 1.4, people with HIV are living longer and healthier lives. This is largely thanks to improvements in HIV treatment.

Even so, people living with HIV still have a lower overall life expectancy than people living without HIV. They also have fewer years of living without other comorbidities than people without HIV.

A comorbidity is the presence of one or more disorder or disease in addition to HIV itself.

For some people living with HIV, the earlier onset of other comorbidities is due to how HIV impacts the body’s immune system and response to inflammatory processes.

For others, they may be linked to the impacts of medications and treatments for HIV. This is especially true for people who received earlier HIV/ART treatments that were untested and often highly toxic.

People living with HIV are more likely to experience:

  • Cardiovascular and lung disease
  • Hypertension
  • Renal impairment and kidney disease
  • Diabetes
  • Obesity and being overweight
  • Hyperlipidaemia (for example cholesterol)
  • Osteoporosis
  • Hepatitis A and B, non-viral Hepatitis and fatty liver disease
  • Other co-infections such as STIs or Tuberculosis
  • Certain types of cancer

Most people (knowingly) living with HIV will have regular interactions with the health system.

These interactions are likely to be more regular if a person has other co-occurring health needs and concerns.

Some people living with HIV may also experience challenges and complications associated with polypharmacy use.

For example, they might experience health complications because of how different drugs interact. They may have difficulty adhering to a complex treatment plan.

These challenges are likely to increase as people get older. People’s tolerance for many drugs can decrease with age. A person may also find it harder to remember things as they age at the same time the number of medications they need to take expands because of additional health needs as they age.

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