Aging AIDS population causes new challenges for health care system

McClatchy Washington BureauSeptember 18, 2013 

— Half of the HIV/AIDS population in the United States will be 50 or older by 2015, a pivotal development that brings new challenges to the treatment and prevention of the disease, experts told a congressional panel Wednesday.

Drug resistance, other diseases, high rates of depression and a lack of prevention, screening and early diagnosis could all pose significant problems as the population of Americans with HIV or AIDS ages, they said during a hearing of the Senate Special Committee on Aging.

As research for a cure for AIDS continues, there is a vital need to examine the aging AIDS population, since any drug or vaccine must now work on an older population, said Sen. Bill Nelson, D-Fla., the committee’s chairman.

“The so-called graying of the population comes with the need to refocus our work on these new challenges,” Nelson said.

Older Americans tend to take fewer precautions against HIV, get diagnosed later and respond less to antiretroviral therapy, said Dr. Ronald O. Valdiserri, a top infectious diseases official with the Department of Health and Human Services.

Older people with HIV are more likely to develop cardiovascular disease, cancer, and liver and kidney disease, as well as depression, the experts said.

These factors result in a need for increased funding for prevention, treatment and biomedical research, they said.

Even though AIDS patients are getting older, many are still under 65, meaning they are not eligible for Medicare or other services funded through the Older Americans Act, said Daniel Tietz, executive director of the AIDS Community Research Initiative of America.

Tietz called for more funding for the Centers for Disease Control and Prevention’s HIV initiatives, as well as the federal Ryan White HIV/AIDS program, which provides primary care and support to patients who can’t afford it independently.

The Affordable Care Act, the 2010 health care law, is critical in bringing care to older HIV-positive adults, Tietz said. By expanding Medicaid, eliminating co-payments for services like HIV testing and providing HIV medication coverage, the health care act will improve care available to HIV/AIDS patients, witnesses said.

Tietz also said better screening is needed, saying HIV testing should become as common as blood-pressure readings.

Other experts echoed the call for better funding for HIV-related programs.

With so many different organizations working against HIV/AIDS, the fight against the disease must become “an integrated effort,” said Carolyn L. Massey, who was diagnosed with AIDS in 1994.

“The aging adults being diagnosed with and living with HIV, if left unattended, is one of the next big health challenges we will face as a nation,” Massey told the committee.

Email: jmcdaniel@mcclatchydc.com

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