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Older People With HIV Face Multiple Disadvantages, Study Finds, UK

November 21, 2011

People with HIV aged 50 and over are now set to live into later life, thanks to medical advances, but are substantially more disadvantaged than their peers in the general population. According to '50 Plus', the first national study of ageing and HIV, launched tomorrow in Vienna at AIDS 2010, the 18th International AIDS Conference, by charities Terrence Higgins Trust and Age UK for The Joseph Rowntree Foundation, they have worse health, are poorer and fear for the future.

Findings show that older people living with HIV are twice as likely to experience other long-term health problems alongside HIV, such as high blood pressure, kidney and liver problems and arthritis, with two thirds having treatment for these conditions.

This group is also financially disadvantaged in comparison to people their age without HIV. They are less likely to be working, less likely to have a financial cushion for their retirement and more reliant on state benefits. Many have serious financial worries for their future. Older people with HIV are less likely to be homeowners and more likely to live in social or private rented housing. One respondent commented: "Since I was diagnosed in 1985 I regarded this as a death warrant and ceased to make any pension provisions."

Older people with HIV state good quality health and treatment information as their highest priority, but three quarters have fears about needing health and social care in the future. One interviewee said: "I also fear that, in case I need to be cared for, the carer would be as ill-informed and prejudiced about HIV as the rest of the general public."

Designed with older people living with HIV, '50 Plus' investigated the needs and concerns of 410 people (one in 25 of all people aged 50 and over living with HIV and currently being seen for care in the UK) to raise awareness of the issues that this group face and advocate for their specific social care needs.

Terrence Higgins Trust's Head of Policy, Lisa Power, said: "As a result of effective treatment options, and our ageing population, the over 50s are now the fastest growing group of people with HIV in the UK, and there's a long way to go regarding support for this group. Older people with HIV are living with high levels of uncertainty about their future health and social care and need substantially more support than their peers.

"The information we've gathered through '50 Plus' is vital in giving us a better understanding of the unique problems that older people with HIV face on a daily basis in the UK. With this insight we can develop support services that are fully tailored to this group's needs to ensure they have the same quality of life as their peers."

Other findings from the report show that:

- Older people with HIV are a rapidly growing and diverse group. The majority of this group are gay and bisexual men but there are also high numbers of African migrants and white heterosexuals. Some are long-term survivors whilst others have been recently infected- one in five respondents (21%) were diagnosed in the 1980s but the greatest number (41%) were diagnosed since 2000.

- Whilst older people with HIV think highly of their HIV clinicians, many report poor experiences in primary care, including discrimination, ignorance and a low standard of clinical treatment, and visit their GPs and generalist healthcare services less than older people in general. Many also fear that social care services, care homes and sheltered housing might be HIV prejudiced and/or homophobic.

- Many report feeling isolated and would like more social contact and support. Most prefer to find this through HIV organisations.

- Most were open about their HIV status in key relationships and have found reactions largely positive; however, disclosing that have HIV is still seen as risky.

In response to these research findings, Terrence Higgins Trust, Age UK and The Joseph Rowntree Foundation are calling for five specific areas of action:

- Improvements in healthcare to ensure access to good quality treatment in all settings and availability of better information to older people with HIV.

- Better employment support, money management courses and benefits advice.

- Addressing homophobia, HIV discrimination and ageism in all services, but especially in social housing, sheltered housing, care homes and health services (particularly primary care).

- Improved emotional support and opportunities for social contact, to prevent isolation.

- Greater cooperation and information sharing between organisations and services for older people, and those for people with HIV, to improve policy and practice.

Michelle Mitchell, Charity Director at Age UK, said: "This report clearly shows that the problems many of us face in later life, such as financial pressures, deteriorating health and isolation are all exacerbated by the impact of HIV on people's lives. Now people are living far longer with HIV than ever before, we need to shift the focus on support services to improving quality of life. To achieve this, it is vital that we increase awareness and understanding of the needs of this group across a range of health, social care, housing and advice services."

The full '50 Plus' report will be available from October 2010 on The Joseph Rowntree Foundation website and both Terrence Higgins Trust and Age UK will be using the findings to inform future service development.

Tags: Old people living with HIV

More Than Five Million People Receiving HIV Treatment

November 16, 2011

An estimated 5.2 million people in low and middle-income countries were receiving life-saving HIV treatment at the end of 2009, according to the latest update from WHO.

WHO estimates that 1.2 million people started treatment in 2009, bringing the total number of people receiving treatment to 5.2 million, compared to 4 million at the end of 2008.

"This is the largest increase in people accessing treatment in a single year. It is an extremely encouraging development," says Dr Hiroki Nakatani, WHO Assistant Director-General for HIV, Tuberculosis, Malaria and Neglected Tropical Diseases.

At the XVIII International AIDS Conference, WHO is calling for earlier treatment for people with HIV. The objective is to begin HIV treatment before they become ill because of weakened immunity.

"Starting treatment earlier gives us an opportunity to enable people living with HIV to stay healthier and live longer," says Dr Gottfried Hirnschall, WHO Director of HIV/AIDS.

Estimates developed through epidemiological modeling suggest that HIV-related mortality can be reduced by 20% between 2010 and 2015 if these guidelines for early treatment are broadly implemented.

Earlier treatment can prevent opportunistic infections including tuberculosis (TB), the number one killer of people with HIV. Deaths from TB can be reduced by as much as 90%, if people with both HIV and TB start treatment earlier.

The strength of a person's immune system is measured by CD4 cells. A healthy person has a CD4 count of 1000 - 1500 cells/mm3. WHO previously recommended starting HIV treatment when a person's CD4 count drops below 200 cells/mm3 but now advises starting HIV treatment at 350 cells/mm3 or below.

"In addition to saving lives, earlier treatment also has prevention benefits," Dr Hirnschall says. "Because treatment reduces the level of virus in the body, it means HIV-positive people are less likely to pass the virus on to their partners."

WHO's treatment guidelines expand the number of people recommended for HIV treatment from an estimated 10 million to an estimated 15 million. The cost needed for HIV treatment in 2010 will be about US$ 9 billion, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS).

"The investments we make today can not only save millions of lives but millions of dollars tomorrow," said Dr Bernhard Schwartlander, Director, Evidence, Strategy and Results, UNAIDS. "People with weaker immune systems who come late for treatment require more complex and costly drugs and services than those who start treatment earlier and are healthier."

Since 2003 - which marked the launch of the historic "3 by 5" initiative to provide access to HIV treatment to 3 million people living in low- and middle-income countries by the end of 2005 - the number of people receiving HIV treatment has increased 12-fold.

At AIDS 2010, WHO is releasing the 2010 guidelines on Antiretroviral treatment of HIV infection in adults and adolescents - public health approach.


Tags: Old people living with HIV


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