“Nobody asked me when I was in my twenties what I wanted to be or what kind of life I wanted to have when I was in my sixties, because I was not expected to live.” explains HIV survivor and lawyer Vince Crisostomo.
Crisostomo, who is now 60, found out he had HIV in 1989, two years after being infected. “People associate a lot of loss with HIV and AIDS, especially my generation. And I was lucky, ”he says.
In the 1980s and early 1990s, many people with HIV lived only one to two years after being diagnosed. But with new treatment and a better understanding of the virus, many people, like Crisostomo, are living long and healthy lives. Today, almost half of all people living with HIV in the United States are over the age of 50.
Advances in HIV treatment
Medicines for HIV have come a long way since the CDC first approved the use of antiretroviral therapy (ART) for this virus. Treatment included numerous pills, a problematic dosage, food and drug interactions, and other severe symptoms.
“At first, we switched drugs because of side effects,” says Janessa Broussard, vice president of medical affairs for the San Francisco AIDS Foundation. “But we’ve reached a point where we have agents who don’t have issues that would concern me with switching my patient to another option. The decisions we make today are tied to individual preferences. “
HIV treatment can still have side effects, but modern ART is much more manageable. Effective treatment routines have made the life expectancy of people living with HIV comparable to that of people without the virus.
“Before having adequate therapy, HIV was, as they say, a death sentence,” says Broussard. “But now, as a provider, it’s a whole different conversation I have with my patients, which is wonderful. I can honestly say that it really won’t affect your lifespan. You can still live a long, happy, and healthy life. “
HIV and complications of aging
As people live longer with HIV, age-related health issues have become a new challenge. While anti-HIV treatments reduce the risk of AIDS-defining illnesses, some non-AIDS-related conditions are more common in people aging with HIV. Some of them include:
People living with HIV may also notice these conditions earlier in the aging process than their peers without HIV. Researchers aren’t sure exactly why this happens, but believe it has to do with changes in the immune system leading to age-related complications that start earlier.
Aging and HIV are also both linked to chronic inflammation, which could lead to many health problems.
In addition, long-term ART could lead to complications such as osteoporosis, a higher risk of fractures, kidney and metabolic disorders, liver disease, cardiovascular disease, and central nervous system disorders. But experts have a hard time saying whether ART is the direct cause of these conditions, or if they are due to a combination of long-term ART and other factors.
A person’s genetics, lifestyle, length of time between infection and starting antiretroviral therapy, and other medical barriers could also affect the risk of these age-related problems.
“With age, many people develop chronic illnesses that require medications that also have side effects,” says Broussard. “It’s hard to say directly that long-term antiretrovirals cause a certain condition. They may have contributed to the development of certain conditions. But if you take a risk / benefit perspective, antiretrovirals – even with their effects – are significantly better than the effect HIV has on the body when not controlled by therapy. “
Aging well with HIV
It is important to start ART as soon as possible, even if you are diagnosed later in life. Additionally, there are many things you can do to live a long, healthy life with HIV:
Find a doctor who meets your needs. Your healthcare professional should understand the needs of an aging person with HIV. Your physical, mental, and emotional needs may be different from those of others. It is important that your doctor realizes these potential differences and is trained to give you the care you deserve.
See your doctor regularly. Ask your doctor how often you should have a routine checkup. They will be able to test your urine and blood to see if anything has changed or if you have an undetected viral load, which means the virus is not having as much of an impact on your body. As with any other condition, it’s a good idea to monitor your condition and let your doctor know if you notice any changes.
Make healthy lifestyle choices. You can reduce your risk of getting age-related illnesses by not smoking, limiting alcohol consumption, and avoiding recreational drugs.
Eat well and exercise. Maintaining a healthy weight can also help you avoid health complications. Eat balanced meals and exercise often to stay in shape. Lifting weights can also help keep your bones strong, which helps fight the side effects of osteoporosis.
Seek out social support. Support groups and communities can help you discuss your experiences and connect with other people aging with HIV. You can find groups that meet online or in person. Also, talking to those close to you can help you express your feelings and allow them to understand your point of view.
Maintain mental health. Your mental health needs change with age. It is important that you focus on your mental well-being, in addition to your physical health. Older people living with HIV are at higher risk of mental health problems and social isolation than HIV negative people of the same age. This is due to the stigma, the loss of friends and loved ones, and the normal side effects of HIV, ART and the aging process.
Thrive as you age
Crisostomo says that these days he is working to change mindsets. “I have never planned a trip in my adult life a year in advance. I never had any goals except to get through the day or the month. I’m trying to change that, ”he says.
Today, more and more people are aging with HIV and exploring a chapter in their lives that they thought would never come. “People can have relationships, be loved, have children who are biologically related to them,” says Broussard. “This is a stark contrast to the lives of people living with HIV in the 1980s and 1990s.”
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