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Video of US Senate Hearing on HIV & Aging Sept 18, 2013
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>50 Yrs old: 33% in NY in 2008 , 52% in SF in 2010
(soon >50% of HIV+ will be over 50 & 30% will be >60. we need to better understand the cause although we have some understanding, better prevention, intervene with diagnosis sooner, and find a treatment intervention for patients who are already >50 yrs old. Diet & exercise are as of now the BEST intervention to prevent early onset of comorbidities & inflammation, that means early start of vigorous exercise (250+ minutes a week of vigorous aerobic exercise) and a diet resembling a mediterranean diet: fish, chicken, vegetables, fruit, beans, nuts.
Senate Aging/HIV Hearing Sept 18 2013
LINK TO VIDEO OF HEARING -
http://www.aging.senate.gov/hearing_detail.cfm?id=345657&
Sen Nelson of Florida said "30% are over 50 now and in 2 years 50% will be over 50.....in Florida 39% are >50".....Sen Collins of maine said HIV+ are experiencing comorbidities a decade sooner.....Sen Warren stated "52% in her state Mass with HIV are >50 yrs old & 15% are 60 or older".
CDC: In 2009, CDC surveillance data estimated that 33 percent of persons living with HIV infection were age 50 or older; by 2020, this age group may represent half of those living with HIV infection.[1]......Kenny Miller said "The state of Maine is often regarded as one of the grayest states in the nation, with 17.5% of the population aged 65 and up (35). With only 1,654 people living in Maine diagnosed with HIV as of December 2012, Maine is considered a 'low incidence' area (14). Reflecting the aged nature of Maine's population, roughly 50% of persons living with HIV in the state are age 50 or older (14)."
FIGURE 2- Estimated numbers of persons living with HIV, by year and selected characteristics in (a) 2007 and (b) 2009: 46 states with confidential name-based reporting of HIV infections to the Centers for Disease Control and Prevention.
Note. In 2007, the median age was 40-44 years, and 28.6% were aged ≥ 50 years. In 2009, the median age was 45-49 years, and 32.7% were aged ≥ 50 years.
[1] Brooks, John T., et al. "HIV infection and older Americans: The public health perspective." American Journal of Public Health 102.8 (2012): 1516-1526.
from the CDC: http://www.cdc.gov/hiv/topics/over50/index.htm
Persons aged 50 and older accounted for
· 15% of new HIV/AIDS diagnoses [1]
· 24% of persons living with HIV/AIDS (increased from 17% in 2001) [1]
Additionally, in 2005, there were racial/ethnic disparities in HIV/AIDS diagnoses among persons 50 years of age and older. The rates of HIV/AIDS among persons 50 and older were 12 times as high among blacks (51.7/100,000) and 5 times as high among Hispanics (21.4/100,000) compared with whites (4.2/100,000) [2].
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Morbidity and Aging in HIV-Infected Persons: The Swiss HIV Cohort Study
Clinical Infectious DiseasesOct 13 2011
http://www.natap.org/2011/HIV/102111_02.htm
"One hundred one (4.5%) of 2233 participants aged 50-64 years and 23 (5.3%) of 450 participants aged >65 years had ≥4 comorbidities." In looking at table 3 you can see increased rates of NonAIDS Comorbidities in 50-64 age group compared to <50: cerebral infarction, coronary agioplasty, other CVD diseases, fractures, osteoporosis, diabetes, liver events, pancreatitis, malignancies, kidney events.
Multivariable hazard ratios for stroke (17.7; CI, 7.06-44.5), myocardial infarction (5.89; 95% CI, 2.17-16.0), diabetes mellitus (3.75; 95% CI, 1.80-7.85), bone fractures without adequate trauma (10.5; 95% CI, 3.58-30.5), osteoporosis (9.13; 95% CI, 4.10-20.3), and non-AIDS-defining malignancies (6.88; 95% CI, 3.89-12.2) were elevated for persons aged ≥65 years.
Health Department Reports 75% of New Yorkers Living with HIV/AIDS Are 40 or Older and More than a Third Are over 50
Persons living with HIV/AIDS (PLWHA) in New York City are aging. In 2008, more than one-third (37%) of PLWHA were aged ≥ 50. Between 2004 and 2008, the numbers of PLWHA aged ≥50 increased by 45% (19,840 to 28,761) in males, and by 58% (6,675 to 10,542) in females.
"In 2007, the most recent data available, nearly 120,000 New Yorkers were living with HIV/AIDS. Of these, 35 percent were ages 50 and older. In contrast, in 2002, there were approximately 90,000 New Yorkers with HIV/AIDS, and older adults represented 23 percent of the total." From Jules: that's an increase by 50% over 5 yrs from 2002 to 2007
http://www.natap.org/2010/newsUpdates/071910_01.htm
http://www.natap.org/2009/newsUpdates/092109_04.htm
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People fifty years or older now account for the majority of AIDS cases in San Francisco, California, 2010
AIDS Care, 2013. Kara J. O'Keefe a , Susan Scheer a , Miao-Jung Chen a , Alison J. Hughes a & Sharon Pipkin a a San Francisco Department of Public Health, San Francisco, CA, USA
http://www.natap.org/2013/HIV/052913_04.htm
At the end of 2010, 9796 persons were living with AIDS in San Francisco. Of these, more than half (5112 or 52%)were 50-years old or older.
also
From 1990 to 2010, the annual number of AIDS diagnoses in San Francisco declined from 2047 in 1990 to 331 in 2010, yet, the age at AIDS diagnosis increased (Figure 1). In 1990, 10% of the people diagnosed with AIDS in San Francisco were aged 50 years or older, compared to 28% in 2010
The aging of PLWA creates new health concerns for communities caring for AIDS patients. Older people with HIV/AIDS face both HIV/AIDS-related and age-related co-morbidities, such as hypertension, chronic pain, hepatitis, and arthritis, which are associated with poorer physical, mental, and social wellbeing (Balderson et al., 2012). A National Institutes of Health-commissioned HIV and aging working group has emphasized the need for research on the interaction of age and HIV infection and also on the necessity for increased community support, caregivers, and systems infrastructure (High et al., 2012). The aging nature of the HIV/AIDS epidemic is significant and will continue given current trends in older age at diagnosis and declining deaths.
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