Is There no Place for Us? The Psychosocial Challenges and Rewards of Aging with HIV

Abstract According to the Centers for Disease Control and Prevention (CDC), nearly half a million people aged fifty years and older have human immunodeficiency virus (HIV) in the US. This population will continue to grow and some estimates suggest that approximately 70% of all persons with HIV (PWH) in the US will be 50 and over by 2030. This pattern is found globally, as access to antiretroviral therapy becomes widespread. This population includes newly infected older adults and long‐term survivors aging with HIV. This article reviews the challenges and opportunities for older PWH, focusing primarily on psychosocial issues. While the growth of this population testifies to the success of HIV treatments, older PWH encounter numerous difficulties in later life, including high rates of multi‐morbidity, behavioral health issues, HIV stigma, and social isolation. Many older PWH face difficulties finding care in fragmented systems poorly aligned for the dual challenges of aging and having HIV. We address these structural problems and misalignment with eight policy recommendations to improve access to care and support healthy aging. These recommendations fall into three main categories: 1) increased recognition of this population in planning and the National HIV/AIDS Strategy, 2) improved access to programs through the Ryan White and Older American's Act programs, and 3) better surveillance data on this population globally. Short of a cure, the dramatic increase in the population of older PWH will continue for the foreseeable future. It is the duty of advocates, gerontologists, health and social service providers, and policymakers to meet the needs of those growing older with HIV.