Wednesday, February 25, 2009

HIV Under Reported





Aging, and HIV - Under Reported, and Misunderstood


The number of people over 50 years old who are HIV positive being under-reported. With current information stating that the infection rate is around 8 % of all newly reported infections. In addition to this, the number of people who are HIV positive and are 50 years old and older, is rising. The fact that HAART's (highly active antiretroviral therapy) are now helping people to live longer, means that men and women with HIV/AIDS are now facing the challenges of living with the disease, along side the effects of aging.
Many of the effects that HIV/AIDS or the ARV's (anti-retrovirals) have on health are similar to that of aging. This creates challenges in knowing what the causes of certain conditions are. The following conditions are common to both age, and HIV infection:
- Immune function decline
- Cardiovascular diseases
- High blood pressure
- Kidney disease
- Cancers
- Diabetes
- Dementia
- Depression
- Nutritional problems
- Sexual dysfunctions
It is unfortunate, but adults over 50 years of age do not participate in many clinical trials. This is helping to fuel the lack of data on the older adults and antiretroviral therapy. Some studies do indicate that the ARV's are just as effective in older people as they are for younger people.
However, it may be partly due to the fact that older adults tend to follow their HIV prescription therapy better than younger adults. Adherence to HIV therapy is important as it offers fewer chances for the virus to adapt and grow strong again. Non-adherence often leads to patients having to switch from a single ARV therapy to a cocktail of two or three anti-AIDS medicines.
Side effects of the medicine do not seem to be any more frequent in older adults, however they may be felt to be more severe. Also, it is worth noting that CD4 counts may not increase as much in older people.
There is a mistaken belief out in society that older adults are not at risk of contracting HIV/AIDS. This is simply not true, but due to this belief, many older people are diagnosed late. A consequence of this is delayed treatment, depending on which specialist you refer to, can be a good thing or a bad thing.
Those who are diagnosed later in life also face a dual stigma. Our society holds negative attitudes towards HIV and AIDS, as well as aging. As a consequence, older adults who are diagnosed more commonly experience depression.
For those who are newly diagnosed, there are some very specific screening tests which should accompany routine tests for monitoring HIV. These following tests can be an effective tool for you and your doctor to measure health, and identify early on, conditions related to HIV, AIDS, and aging:
- Bone density exam
- Blood pressure
- Fasting blood glucose
- Lipids profile
- Kidney function
Recognizing and addressing problems early on is key to successful treatment. Addressing depression and anxiety in older adults, as well as young adults, can ensure adherence to the treatment guidelines as set out by the doctor. It also serves to ensure regular health care visits, participation in social activities, and personal relationships which include a healthy sex life. Non-adherence can lead to declining health for individuals, and more virulent strains of HIV/AIDS which require more financial resources to manage.

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