HIV Treatment: The Challenges for Older AdultsEn Español (Spanish Version)
Improved medications have helped many people with
live longer, but treating older adults with HIV presents some unique challenges.
The challenges related to diagnosing
in older adults have been well documented. Both doctors and their patients can sometimes feel uncomfortable discussing risk factors, such as unprotected sex and injection drug use. Also, symptoms of HIV can mimic symptoms of other conditions common in older adults.
Once a diagnosis is made, however, there are additional challenges for older adults with HIV and the doctors who treat them. The most effective combination of drugs can interact with medications these adults frequently take for a host of other conditions, such as
high blood pressure
The protease inhibitors that are a critical part of treating HIV inhibit an enzyme in the liver that metabolizes other medications, raising the risk of drug interactions.
Generally, your doctor will try to avoid prescribing drugs that interact. In some cases, that may not be possible since the drugs are necessary.
Another issue is getting people to remember to take all of their medications.
One of the most common reasons people with HIV do not take their medications is because they forget. Forgetting to take medications can be very serious for someone with HIV. Taking medications on a regular basis helps maintain or decrease the amount of the virus in the body, called viral load.
The decrease in viral load improves overall health and quality of life. Evidence from one study found that people who took their medications 95% or more of the time spent less time in the hospital, and had fewer infections, and deaths.
There is good news, however, on two fronts. Those who take their medication have a better chance of getting a positive response. And older adults may experience the same benefits from treatment as do younger people. Seniors also may demonstrate adherence because they may be more used to medication routines.
Also, new regimens are helping people get a better handle on their health. These include taking less pills per day, which makes it easier to adhere to treatment plans.
National Institute of Allergy and Infectious Diseases
US Department of Health and Human Services
Public Health Agency of Canada
Antiretroviral therapy for HIV infection. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated January 30, 2015. Accessed March 6, 2015.
Gebo KA, Justice A. HIV infection in the elderly.
Curr Infect Dis Rep. 2009;11(3):246-254.
Gebo KA, Moore RD. Treatment of HIV infection in the older patient.
Expert Rev Anti Infect Ther. 2004;2(5):733-743.
Mills EJ, Nachega JB, et al. Adherence to HAART: A systematic review of developed and developing nation patient-reported barriers and facilitators.
PLoS Med. 2006;3(11):e438.
Paterson DL, Swindells S, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection.
Ann Intern Med. 2000;133(1):21-30.
Ship JA, Wolff A, et al. Epidemiology of acquired immune deficiency syndrome in persons aged 50 years or older.
Journal of Acquired Immune Deficiency Syndromes.
Silverberg MJ, Leyden W, et al. Older age and the response to and tolerability of antiretroviral therapy.
Arch Intern Med.
Walker AS, Doerholt K, et al. Collaborative HIV Paediatric Study (CHIPS) Steering Committee. Response to highly active antiretroviral therapy varies with age: The UK and Ireland Collaborative HIV Paediatric Study.
Workowski KA, Berman S, et al. Sexually transmitted diseases treatment guidelines, 2010. MMWR. 2010;59(No. RR-12):1-110.
Last Reviewed March 2015