HIV/AIDS and older adults in the United States

HIV/AIDS and older adults in the United States

Arguing the cost-effectiveness of HIV screening for older adults

This newsletter reviews some recent research on ageing and HIV/AIDS, trying to figure out HIV/AIDS risk factors and the cost-effectiveness of HIV screening for older adults in the US.

The paper notes that longevity has increased for those with HIV and AIDS thanks to the success of antiretroviral medications. However, some outcomes for older adults with HIV/AIDS are not as good as for younger adults. Indeed, mortality rates are higher for older adults with AIDS, and survival time after diagnosis is shorter. That is to say the presence of multiple diseases is more common in HIV-infected patients than in other patients.

In addition, the main findings of the paper are the following:

  • older HIV-infected adults are more socially isolated than younger HIV-infected individuals
  • early identification of HIV may prevent irreversible damage to the immune system and reduce complications associated with the disease
  • early diagnosis also offers an opportunity to reduce transmission of HIV through changes in risk behaviour
  • characteristics and care needs of the older HIV population vary both by race and by the origins of their exposure to HIV
  • because prevalence of HIV is lower in older adults, the benefits relative to costs of screening may not be as high for older people as for younger ones

On the other hand, concerning HIV-screening in the US, the paper shows the following recommendations:
  • provision for testing adults ages 65 and older is strongly recommended
  • Medicare should cover HIV screening tests for at-risk beneficiaries and for those beneficiaries who request the service
  • small community samples and qualitative studies should be considered, noticing that much of the information on social service aspects such as caregiving comes from them, not from population-based samples or large-scale surveys