AIDS Community Research Initiative of America (ACRIA) - Summer 2004

This issue of ACRIA Update discusses a topic of rapidly growing importance to the HIV community and public health system nationwide - the aging of the United States HIV population. ACRIA became interested in pursuing research around the health and supportive needs of people living with HIV/AIDS (PLWAs) who are 50 or older three years ago when this group was identified as an emerging special needs population by our Research Policy Advisory Committee for New York State.

Limited research exists on the HIV-positive over 50 population. It is a fairly recent phenomenon that the aging HIV population is growing. Until the introduction of HAART, most people with the virus lived a relatively short time. Most were never able to celebrate completing their fifth decade.

So many questions from epidemiology, clinical, behavioral and policy standpoints remain unanswered. What difference does being over age 50 make when living with HIV? How many people are infected after age 50? What percentage are infected before 50 but only find out their HIV status after 50? How many are living with HIV past 50? What is the effect of aging and chronic infection with HIV? What are the differences between being HIV-positive over 50 and HIV-negative over 50? Is disease progression different for people with HIV who are over 50 compared to those under 50? Are stigma issues more pronounced for the older HIV-positive population? What about delivery of services to an aging HIV population? For many years, service providers and policy makers have prioritized culturally appropriate services. Is it time for us to stress the need for age-sensitive services? Should AIDS service organization staff be educated about issues such as menopause and hypertension?

We are very fortunate to have Andrew Shippy, Research Associate at ACRIA, present a discussion of many issues facing HIV-positive individuals as they age past 50 years. Coincidentally, this article also highlights significant gaps in knowledge about key issues of importance to older PLWAs. ACRIA's Medical Director, Jerry Ernst, MD, has contributed an article that discusses some of the common diseases and conditions that older PLWAs may face while continuing to manage the complexities of HIV. It, too, touches upon some of the unknowns of HIV in an aging population.

Finally, but perhaps most importantly, we've included a number of personal PLWA perspectives to offer our readers a snapshot of how older individuals are coping with this disease. We asked these men and women to focus on their experience of being over 50 and living with HIV. A particularly noteworthy aspect of the personal perspectives is that some hardly touch on aging issues, while others speak specifically about dealing with them. Perhaps for some people, living with HIV is living with HIV and aging doesn't stand out as a particularly heightened concern. For others, age-related issues such as heart disease, hypertension, osteoporosis, and depression make living with HIV an even greater challenge. Another aspect of the personal perspectives is that, for the first time, we have been asked not to identify some authors by name, possibly indicating that stigma for older PLWAs is a greater concern than for many of their younger counterparts.

Obviously, we've identified many more questions than answers. ACRIA is making a lasting commitment to conduct research on health and supportive needs of PLWAs as they age. It is a part of our work in which we hope to make significant progress in the months and years to come. Hopefully, this issue of ACRIA Update will, in some small way, contribute to this purpose.

J Daniel Stricker, Editor in Chief

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Copyright © 2004 - AIDS Community Research Initiative of America. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, ACRIA Update, 230 West 38th Street, 17th Floor, New York, NY 10018; (212) 924-3934; Fax (212) 924-3936 .

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