Advances in HIV treatment have extended the longevity of people living with HIV and, as a result, more people are growing older with the virus and living well into their senior years comparable to the general population. As of 30 September 2019, it is estimated that 5,568 people are living with HIV in Scotland, where 43% are over the age of 50. A large body of evidence highlights that with complex health concerns, fewer financial resources, greater isolation, and experiences of stigma and discrimination, many people living with HIV face major life challenges in ageing. This ‘greying’ of the HIV population has prompted a need to understand the health and societal considerations of ageing among people living with HIV. The review considers the health and wellbeing of older adults living with HIV in Scotland and its relationship with quality of life and successful ageing.

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The review highlighted the following:

  • Ageing with HIV is often linked to non-infectious comorbidities, including cardiovascular diseases, hypertension, chronic liver and kidney disease, diabetes, bone fractures and osteoporosis, and non-AIDS cancers;
  • Comorbidity and multimorbidity has been associated with polypharmacy;
  • Older adults living with HIV are more likely to develop neurocognitive disorders, such as HIV-associated neurocognitive disorders (HAND), compared to their younger counterparts, including HIV-associated dementia (HAD), asymptomatic neurocognitive impairment (ANI), and minor neurocognitive disorders (MND);
  • HIV-positive individuals are at greater risk of developing cognitive impairments that can disrupt daily activities, such a non-adherence to medications;
  • Ageing with HIV can exacerbate vulnerability to mental health conditions such as depression, anxiety, distress, and suicidal ideations;
  • HIV-positive individuals aged ≥ 50 often find that they are more socially isolated compared to younger people living with HIV;
  • Utilisation of health and social care services are influenced by many factors which operate at the individual, healthcare, and societal levels. Many barriers to service utilisation for older adults living with HIV are structural in nature, such as inadequate funding, poor service coordination, and poor operational capacity to meet the needs of this growing population.
  • A common theme in the ageing and HIV literature is improving access to employment, benefits, and financial products, and is seen as a critical element in addressing financial insecurity among older adults living with HIV.

Our Living Well: 50+ Review was made possible thanks to funding from Gilead Sciences.