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People with HIV are aging, and the challenges are piling up


People diagnosed with HIV are living longer, and advances in medicine are a big reason why. But aging with HIV comes with an increased risk of other health problems. And some experts worry that if we don't adequately care for this population now, it could undermine decades of progress in fighting the virus. Sam Whitehead from our partner KFF Health News reports.

SAM WHITEHEAD, BYLINE: Malcolm Reid stands in his kitchen in his house outside of Atlanta and pulls up a smartphone app that helps him keep track of all of his medications.

MALCOLM REID: 50.3 milligrams - that's my HIV meds. I have my multivitamins, omega fish oil, vitamin C.

WHITEHEAD: The app is linked to an automated dispenser, which helps Reid juggle the multiple pills he takes each day to treat his HIV, high blood pressure, and Type 2 diabetes. Reid recently celebrated his 66th birthday. He's also celebrating another important milestone - having lived 28 years with HIV.

REID: I'm just happy to be here. You know? It's like, you were diagnosed, and, you know, you weren't supposed to be here. And you're here.

WHITEHEAD: Aging with HIV can bring a host of other health issues, but clinicians, researchers, and advocates say providers often don't have the proper skills to handle them. HIV doctors aren't often trained in geriatrics, and vice versa. Poorer care means worse health and can even lead people to neglect their HIV. Melanie Thompson is an HIV clinician in Atlanta.

MELANIE THOMPSON: Even though the population is not dying from AIDS at the rate that was occurring in the 1990s, people with HIV have more comorbidities than people without HIV at a given age.

WHITEHEAD: Conditions like diabetes, heart disease, and depression, and that can force people to take on the onerous task of coordinating care between a lot of different doctors.

THOMPSON: Multiple consultants - cardiologists, neurologists, kidney doctors, liver doctors - it becomes quite complex.

WHITEHEAD: Taking more medications to manage multiple conditions increases the risk of dangerous drug interactions. Another major challenge is loneliness. Many people aging with HIV have lost friends and family to the epidemic. Heidi Crane is an HIV clinician at the University of Washington.

HEIDI CRANE: I would provide such better care of my patients if I had the ability to write a prescription for a friend.

WHITEHEAD: Isolation can increase the risk of cognitive decline and can lead individuals to stop HIV treatment. And all that care is a lot for the federal Ryan White program to manage. It runs clinics for low-income people with HIV across the U.S. Its patient population is growing and aging, but the program's core funding hasn't changed much in the last decade. That can present tough spending decisions, says Laura Cheever, who oversees the Ryan White program.

LAURA CHEEVER: When you're at a community level and you're seeing you've got a lot of people that aren't getting enough services to even be in care, how do you decide where that next dollar is spent?

WHITEHEAD: Cheever also says researchers still have a lot to learn about the best ways to meet the needs of those aging with HIV. Her agency recently launched a $13 million project to test out ways to better serve them, like how to better screen for conditions like dementia and frailty.

CHEEVER: For many of the people that are aging with HIV - they were sort of pioneers in HIV treatment. And now they're some of the first people to be aging with HIV. So we are learning as we go.

WHITEHEAD: But Jules Levin, who runs the National AIDS Treatment Advocacy Project (ph), worries it's too little, too late. The 74-year-old has been living with HIV for nearly 40 years.

JULES LEVIN: Frankly, it's ageism on a vast scale by our federal government, by our researchers, and by the advocacy community as well, because they have ignored the problem to a large degree.

WHITEHEAD: Levin worries if that trend continues, it could have dangerous implications for the health of those like himself who have already survived so much.

MARTÍNEZ: Sam Whitehead is correspondent with our partner KFF Health News. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Sam Whitehead
[Copyright 2024 NPR]