Older Adults with HIV/AIDS: A Growing Population

Older Adults with HIV/AIDS: A Growing Population

By Brian Altman, Deputy Director, Administration on Aging, ACL

September 18th marks National HIV/AIDS and Aging Awareness Day—a day we celebrate the growing number of people living long and active lives with HIV. When HIV emerged in the early 1980s, people who contracted the virus could expect to live only a few years with their diagnosis. Thanks to advances in treatment, people who are 50 and older, many of whom have been living with HIV for decades, are a large and growing population. Research has shown that people with HIV who are successfully treated with antiretroviral therapy can have a lifespan similar to that of their HIV-negative peers, living well into their 70s and 80s. Currently, over half of adults living with HIV are over the age of 50, and by 2030 over 70 percent of the HIV positive population in the United States will be over 50; older people of color are disproportionately affected by HIV, as are older men who have sex with men.

September 18th is also a day to raise awareness of the aging-related health and social service needs of older adults living with HIV. They are an extremely diverse population with distinct needs that will continue to evolve as they age.

With its extensive experience providing services to meet the need of a growing, and increasingly diverse, population, ACL’s aging network plays an important role in the lives of older adults across the country. Armed with the array of programs funded by ACL to help older adults stay healthy, active, and living in their communities, the network is helping support the healthy aging of people living with HIV. For example: OAA Health and Wellness Programs

Most programs and services provided by the aging network can be beneficial for people aging with HIV, but a few, such as the Positive Self-Management Program (PSMP) developed at Stanford University more than 20 years ago, are specifically designed for people living with HIV. With a grant from ACL under the OAA Chronic Disease Self-Management Education program, the Central Maine AAA recently began working with MaineGeneral Health’s Horizon Program to implement PSMP for older Mainers with HIV..
Programs don’t need to be specifically focused on HIV – many of ACL’s health and wellness programs can be tailored to the needs of older adults living with HIV. Open Hand Atlanta is offering chronic disease self-management education to people living with HIV in conjunction with their signature nutrition and education programs and services. The Council for Jewish Elderly in Illinois, a 2021 recipient of a falls-prevention grant from ACL, is implementing two programs that will reach over 1,300 older people in Illinois and New York living with HIV and/or in low-income, minority, and LGBTQ+ communities.

Insurance Counseling

ACL programs help people living with HIV access critical insurance to pay for medical care and medication. State Health Insurance Assistance Programs (SHIPs) provide counseling and guidance to help people navigate complex enrollment and benefits decisions in Medicare and other health insurance programs.

SHIPs also are collaborating with other HIV service providers to meet the needs of people aging with HIV. For example, many people living with HIV who become eligible for Medicare due to age or disability are also eligible for the Ryan White program, which provides health care and supportive services to moderate-income individuals living with HIV. Coordination of benefits issues can arise when someone receiving Ryan White services becomes eligible for Medicare or other insurance programs and participates in multiple programs simultaneously.

The staff and volunteers of the Iowa SHIP participated in cross-training with the state’s Ryan White program grantees to improve their ability to address these complex benefits questions and better meet the needs of people participating in both programs.

New State Plan Guidance

ACL recently updated its State Plan Guidance, which provides instructions for states to follow when developing their multi-year state aging services plans and details target populations that should be a focus of each state. For the first time, this guidance requests that states include a description of strategies to serve older adults living with HIV, as well as the objectives and measures (data elements and sources) the state will use to demonstrate progress.

The State Plan Guidance applies to plans developed and submitted to ACL starting in 2022, but some states are leading the way. Illinois and California included efforts targeting older adults with HIV for aging services in the plans they submitted in 2021.

Support for the Aging Network

To ensure inclusivity and cultural competency, ACL funds a number of resource centers dedicated to providing support and guidance to grantees on how to best serve the needs of diverse older adults and people with disabilities. One example is the National Resource Center on LGBTQ+ Aging, which includes resources and training for ACL network partners serving older adults with HIV. The reach of the ACL aging network allows it unique access to address the health and social support needs of older adults living with HIV, and ACL’s programs provide powerful tools to support them in healthy aging. On this day of observance and celebration, we should also look to the future and develop creative and sustainable ways to best serve the diverse populations of older adults in our communities, which include an increasing number of people aging with HIV.
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