Aging with HIV: Working to Ensure Equity and Inclusion

Abstract

Due to effective anti-retroviral therapy (ART), the people with HIV are aging, and this is observed globally wherever ART is readily available. While this represents the success of HIV treatment, those aging with HIV face several health challenges that emphasize the importance of access to health care and health equity. These challenges include changes to the immune system, chronic inflammation, and higher rates of multimorbidity at younger ages compared to people without HIV. Intersectional identities impact health care access and health equity and include age, sexual orientation, gender identity, race/ethnicity, socioeconomic position, and HIV serostatus. Intersectional identities are also associated with psychosocial burdens among older adults with HIV such as depression, social isolation, and HIV stigma. Social integration of older people with HIV can mitigate some of these burdens and is associated with better psychological well-being, better physical functioning, and greater sufficiency of informal social supports. There are several grassroots and advocacy initiatives to improve health equity and social integration which bring greater visibility to HIV and aging. These efforts should be coupled with a systematic and sustained policy response to the aging of this population that prioritizes human needs and is grounded in principles of social justice. Action must be taken, and this responsibility falls on policymakers, health care professionals, researchers, and community advocates alike.

Keywords: Behavioral health; HIV/AIDS; Inclusion; Multimorbidity; Resilience; Stigma.