Living and aging well with HIV—new strategies and new research

November 30, 2017 by Allison Webel, The Conversation
In honor of National Women & Girls HIV/AIDS Awareness Day, Raheem DeVaughn sings to hundreds of women gathered at the launch of the national campaign on Wednesday, March 8, 2017, in Oakland, California. Credit: Invision for AIDS Healthcare Foundation/AP Images/Peter Barreras

A generation ago, a list of tips for aging well with AIDS would have seemed a cruel joke. It also would have not been useful. Life expectancy immediately following the identification of the virus in 1984 was often months after diagnosis.

Today, however, with World AIDS Day being commemorated for the 30th year, many people with HIV are living as long as the general population.

But while people with HIV are living longer, they are also living with unique challenges regarding how to age well. New evidence suggests that there are indeed several simple but vital strategies that can help increase the likelihood of successful aging.

As a nurse and a scientist, I study effective self-management strategies and have seen what a difference they make to adults aging with HIV.

Aren't we close to a cure for AIDS?

First, a reminder of the scope of HIV. There are an estimated 36.7 million people who have the virus. Despite the virus having been identified only in 1984, more than 35 million people have died of HIV or AIDS, making it one of the most destructive pandemics in history.

Due to highly effective HIV medications, fewer than 7,000 people died from HIV-related causes in the United States in 2014. That means people living with HIV are aging. In the United States, 45 percent of all people living with HIV today are aged 50 years or older. Worldwide, about 10 percent are 50 or older, a number expected to rise, provided the medications continue to be made available.

Indeed, the past few years we've made remarkable progress toward an HIV cure. Building on what we've learned from Timothy Ray Brown, the only individual ever known to be cured of HIV, scientists have discovered treatments in very preliminary studies that dramatically reduce the HIV reservoir (cells where HIV accumulates in someone's body) and that stop all viral activity in infected cells, and they have visualized the last unknown HIV protein structure, which will help us better target the HIV virus.

Further, the "Undetectable Equals Untransmittable" campaign has brought much-needed public awareness to the fact that people infected with HIV who are virally suppressed through medication cannot sexually transmit the virus.

Yet, despite all of this hard-earned progress, many scientists believe we are still decades away from a true HIV cure. While this important work continues, over 36 million people infected with HIV will continue to age and will seek out accessible strategies that enable them to live their lives to the fullest extent.

Why aging with AIDS is difficult

Aging isn't easy for any of us. Our bodies aren't quite as fast as they used to be, recovery time is longer and we have a few more aches than when we were younger.

So is it actually harder for people living with HIV to age well? Research shows that it is. Specifically, they experience:

In the present: Live well

There is no magic bullet for aging well, no matter your health status. Everyone needs to take their medications as prescribed, get a good night's sleep, manage stress and see a health care provider regularly. However, there is new evidence that suggests that three promising, nonpharmacological strategies can help adults with HIV.

Yet these strategies can be hard to engage in, particularly for a historically marginalized population that is dealing with aging for the first time. Several investigators, including my team, are studying new ways to help this aging population.

Over the past three years, my research team conducted a clinical trial with 109 HIV-positive adults to see if a group-based intervention improved exercise and healthy eating. In November, at the American Heart Association Scientific Sessions, we reported that our behavioral intervention reduced carbohydrate intake, specifically the consumption of sugar-sweetened beverages. However, we failed to improve physical activity in aging adults with HIV. Recently, others have reported that their interventions also did not increase physical activity, and suggest that a new, personalized approach to initiating and maintaining physical activity in this population is needed.

Breakthroughs in this area can lead to new treatment strategies to help not only HIV-positive adults age well, but also others who are living with complex chronic conditions.

So while we focus on curing HIV, we must also recognize that a cure is likely several decades away. In the meantime, millions of people struggle to age well with HIV. Our HIV-positive brothers and sisters have shown incredible resiliency over the past 36 years. Together, we undoubtedly will find innovative and personalized strategies to overcome these struggles.

Explore further: Stigma due to age, sexual orientation, HIV status contributes to poor mental, physical health

Related Stories

Stigma due to age, sexual orientation, HIV status contributes to poor mental, physical health

August 4, 2017
When it comes to HIV prevention and treatment, there is a growing population that is being overlooked—older adults—and implicit ageism is partially responsible for this neglect, according to a presentation at the 125th ...

Study finds day-to-day experiences affect awareness of aging, mood

July 20, 2017
A study of older adults finds an individual's awareness of aging is not as static as previously thought, and that day-to-day experiences and one's attitude toward aging can affect an individual's awareness of age-related ...

Self-perceptions of aging

July 19, 2017
In the 1960s, the Beatles sang about wondering whether their true love would still love them as they grew older—after they've lost their hair and are no more adventurous than wanting to knit a sweater.

Reducing frustration with health care is key for those with chronic medical conditions

March 3, 2017
Navigating the U.S. health care system can be frustrating for anyone, but for adults with chronic medical conditions, the frustration can become overwhelming as they juggle multiple providers, medications and treatments.

New findings reveal health, aging experiences of LGBT older adults across nation

February 14, 2017
In a first-of-its-kind study, researchers from the University of Washington's School of Social Work have released new findings this month on the health and aging of lesbian, gay, bisexual and transgender older adults in the ...

Aging with HIV and AIDS: A growing social issue

June 25, 2014
As the first people with HIV grow old, a new study from St. Michael's Hospital questions whether the health care system and other government policies are prepared to meet their complex medical and social needs.

Recommended for you

Study suggests a way to stop HIV in its tracks

December 1, 2017
When HIV-1 infects an immune cell, the virus travels to the nucleus so quickly there's not enough time to set off the cell's alarm system.

Discovery puts the brakes on HIV's ability to infect

November 30, 2017
Viewed with a microscope, the virus faintly resembles a pineapple—the universal symbol of welcome. But HIV, the virus that causes AIDS, is anything but that. It has claimed the lives of more than 35 million people so far.

Rising levels of HIV drug resistance

November 30, 2017
HIV drug resistance is approaching and exceeding 10% in people living with HIV who are about to initiate or reinitiate first-line antiretroviral therapy, according to the largest meta-analysis to date on HIV drug resistance, ...

Male circumcision and antiviral drugs appear to sharply reduce HIV infection rate

November 29, 2017
A steep drop in the local incidence of new HIV infections accompanied the rollout of a U.S.-funded anti-HIV program in a large East-African population, according to a study led by researchers at Johns Hopkins Bloomberg School ...

Combination HIV prevention reduces new infections by 42 percent in Ugandan district

November 29, 2017
A study published today in the New England Journal of Medicine provides real-world evidence that implementing a combination of proven HIV prevention measures across communities can substantially reduce new HIV infections ...

Research on HIV viral load urges updates to WHO therapy guidelines

November 24, 2017
A large cohort study in South Africa has revealed that that low-level viraemia (LLV) in HIV-positive patients who are receiving antiretroviral treatment (ART) is an important risk factor for treatment failure.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.