Older people and living with HIV

I am a front line nurse writing about older people, living with HIV infection. Older people are living longer with HIV across the UK, where there is access to treatment. This is topical in the field of HIV care. I am optimistic this blog will raise awareness of older people living with HIV which is a cause for celebration. However, careful consideration is required whilst providing care and maintaining an independent lifestyle for older people living with HIV.

I had the pleasure of attending RCN Congress in Brighton. There, I excitedly met up with RCN members from the Older People’s Forum. During this year’s Congress a resolution was passed for RCN Council to lobby for a commissioner for older people in Scotland and England. On June 13, Members of the Scottish Parliament (MSP’s) launched a public consultation on the proposed bill for a commissioner for older people in Scotland. I would encourage everyone to engage and support this consultation document.

This week I am writing my first ever blog about older people living with HIV infection. Yes, that’s people living with HIV, to the celebrated ages of 60, 70 and 80. Who would have thought that? Not me. Particularly, as a newly qualified nurse in Edinburgh, in the 1980’s, where a generation of people were lost to HIV infection.

HIV is no longer a terminal illness. HIV is now a chronic health condition which can have overwhelming effects on the health and well being of people. Early diagnosis and effective treatment means the HIV virus can be suppressed and prevent onward transmission. Yes that’s right, undetectable means untransmitable (U=U).

Remarkably, HIV transmission through sex can be prevented with treatment when taken as prescribed (PrEP-pre exposure prophylaxis). Testing for HIV infection is a real opportunity to stop the spread of HIV. The risk factors for HIV are similar for adults of all ages therefore older people should be tested for HIV infection and be prescribed PrEP as a treatment for prevention.

Around 48 per cent of people living with HIV infection are aged 50 or over and eight per cent are 65 or over. This is a result of highly effective treatment. However there remain adverse impacts on physical and mental health. Living with HIV can worsen existing inequalities and experience additional HIV related stigma and discrimination. Currently, older people living with HIV in UK find themselves with unique needs that may be challenging for our four nation’s health and social care systems. Older people living with HIV can experience multiple co-morbidities at the same time. This can contribute to frailty and disability.

HIV clinicians, now recognise the need for multidisciplinary assessment in managing older people living with HIV focusing on preserving physical function. There is a need to focus on prevention and early intervention through established community health and social care services. Preferably to avoid admission to acute care. Avoidance of 'poly-pharmacy' 'falls prevention' and 'frailty scoring' is becoming a regular function in the HIV clinic for older people living with HIV. Older people cannot stop the ageing process but can make lifestyle changes to keep bodies stronger and healthier and managing HIV well is essential to this.