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  4. HIV/AIDS

HIV/AIDS

More than 1 million Americans are currently living with HIV, and it is a group that is aging quickly. In 2018, over half (51 percent) of HIV-Positive Americans were 50 or older, and demographics indicate that the population of HIV-positive older adults are likely to grow significantly for the next two decades. While this represents a major public health achievement—as more individuals with HIV are enjoying longer, healthier lives through access to effective care and management—it also represents new opportunities as well as obstacles for long-term HIV survivors, their caregivers, aging service providers, and HIV/AIDS service providers.

In addition, a significant portion of new HIV infections occur among older adults. In 2018, 17 percent of new HIV diagnoses in the US were adults age 50 and older. However, older adults have the longest delay in being diagnosed with HIV for any age group. Among adults age 55 and older who received an HIV diagnosis in 2015, 50 percent had HIV 4.5 years before they were diagnosed. It is clear that more needs to be done to inform people and aging network providers about the importance of educating older Americans about HIV prevention and testing.

Accessing Testing and Care  

By accessing and testing HIV/AIDS testing you can manage your HIV/AIDS care. 

Testing and Care

The HIV Testing Sites and Care Services Locator, a location-based search tool, allows people to search for testing services, housing providers, health centers and other service providers at nearby locations: The HIV Testing Sites and Care Services Locator.

The Health Resources and Services Administration funds community health clinics which care for people, even if they have no health insurance. Find a federally funded health center nearby, where people pay what they can afford, based on income.

If transportation is a barrier to receiving HIV testing or health care, the Eldercare Locator can direct people to the local Area Agency on Aging (AAA). Many AAAs provide some form of transportation assistance or referral, as well as other services for older adults and their families.

Find a State's HIV / AIDS Toll-Free Hotline

This toll-free hotline connects people with agencies that can help determine what services they are eligible for and help them get them using State HIV/AIDS Hotlines.

Nutrition and HIV 

Good nutrition is essential for good health, but it is especially important to those living with HIV. Eating nutritious foods is key to minimizing symptoms associated with HIV (such as weight and muscle loss, diarrhea, and high levels of cholesterol and triglycerides) and maintaining strength, energy, and a healthy immune system required to fight other infections. Good nutrition also improves the absorption of medicines and helps manage potential side effects. 

Nutrition and HIV

People with HIV sometimes face issues that can affect their nutrition, including changes in the body’s metabolism, medicines that can upset the stomach, and infections that can cause problems with eating and swallowing.  Individual nutritional needs should be considered for those with HIV and AIDS; however, general healthy eating patterns are an excellent place to start. Healthy eating suggestions when a virus is under control include:

Consume adequate calories throughout the day to maintain a healthy weight. Those with HIV/AIDS may need to adjust their calorie and protein needs depending on how they respond to treatment. Some individuals may need more calories and protein compared to those who do not have this condition.  Add protein to every meal. Protein is important because it is needed to make, repair, and maintain cells in the body, and it also plays a role in the immune system. Good protein sources include lean meats, poultry, fish, low-fat dairy foods, eggs, beans, and lentils. Include a variety of vitamin and mineral-rich foods. Fruits, vegetables, whole grains, low-fat dairy, and lean protein contain vitamins and minerals that help the body function. The immune system uses zinc and vitamin C, and iron and vitamin B12 are essential for healthy blood cells. Including a variety of nutrient-rich foods helps meet these needs. Discuss dietary and herbal supplements with the health care team. Ask about new supplements before starting them, as some can interact with medications.

If there is a problem with eating, people can ask their senior nutrition provider whether they offer choices or modifications. Slight modifications can be made to meals to increase acceptance and consumption. A Registered Dietitian Nutritionist (RDN) can also develop a personalized nutrition plan when eating is a challenge.

Because HIV affects the immune system, preventing foodborne illnesses is especially important. People with HIV should follow basic safety rules when preparing and eating meals to protect them from food-related illnesses, such as:

Avoid eating raw eggs, meats, or seafood (including sushi and oysters/shellfish) Wash fruits and vegetables thoroughly Use a separate cutting board for raw meats Only consume pasteurized milk or cheese Wash hands, utensils, and cutting boards with soap and water after each use. Water safety is critical, as water can carry a variety of parasites, bacteria, and viruses. To protect against these infections, never drink water at risk for water-borne illnesses (such as water from lakes, ponds, rivers, or streams), and where sanitation is poor.

Diarrhea, nausea, vomiting, sore mouth, and taste changes are common issues that can develop with HIV and make eating difficult.  A customized nutrition plan may be required when the ability to eat is compromised by HIV.

If eating a well-balanced meal is a challenge, the local aging services provider can help. Older adults can receive meals through a home-delivered program or congregate settings such as senior centers and faith-based locations (pending COVID-19 local guidelines). The meals served are nutritious and meet the current Dietary Guidelines for Americans, providing a minimum of one-third of the Dietary Reference Intakes.

Senior Nutrition Program participants value the meals they receive.  Eighty percent of all participants say their senior nutrition program helps them stay in their home, and ninety-six percent would recommend the program to a friend.  For more than half the participants, the meal provides one-half or more of their total food for the day.

Chronic Disease Self-Management Education and HIV 

As older adults living with HIV age, it is imperative to address the complexities of proactively managing their health on a long-term basis.

CDSME and HIV

Chronic Disease Self-Management Education (CDSME) Programs are community-based programs specifically designed to enhance self-management of chronic conditions. They focus on building multiple health behaviors such as physical activity, and skills such as goal setting, decision making, problem solving, and self-monitoring in individual or small-group settings. CDSME programs are also proven to maintain or improve health outcomes of older adults with chronic conditions. Evidence suggests that CDSME programs may also significantly reduce the use of hospital care and physician services, as well as reduce health care costs. In a national study of CDSME programs, participants reported significant improvements in aspects of their care (such as communication with their physicians, medication compliance, and health literacy), better health outcomes (such as self-assessed health, reduction in depression and quality of life), and reduced health care utilization (such as lower emergency room visits and hospitalizations), resulting in potential cost savings.

There are over 30 CDSME programs, of which the most widely disseminated and available are the Self-Management Resource Center suite of programs. . The Positive Self-Management Program (PSMP) is one specific CDSME program developed for older adults with HIV to help them build confidence in their ability to manage their health, navigate medication adherence, and maintain active and fulfilling challenges. Learn more about the PSMP program and find a nearby workshop.

Additionally, people with chronic conditions are at a higher risk for experiencing mental health conditions. Having HIV can be a major source of stress and may complicate existing mental health conditions such as depression, one of the most common forms of mental health conditions people with HIV face. Programs like Healthy IDEAS (Identifying Depression Empowering Activities for Seniors), Program to Encourage Active, Rewarding Lives for Seniors (PEARLS), Screening, Brief Intervention and Referral to Treatment (SBIRT), and Wellness Recovery Action Plan (WRAP) can be useful in helping older adults with HIV manage mental health concerns or behavioral health conditions, such as substance use disorders.

Falls and HIV 

Falls are a threat to the health of all older adults and can reduce their ability to stay independent. Falls are the leading cause for fractures and more serious injuries.  There is an even greater risk for adults living with HIV compared to the general population.  

Falls and HIV

Studies show one out of every three adults with HIV experienced a fall during the past year. Some risks for falls include the number and types of medications taken, poor balance, alcohol and drug use, vision and hearing problems, and smoking. For older adults living with HIV there may be a greater risk of a fall due to underlying low bone density, low body weight, neuropathy, and frailty.

The good news is that falls are preventable and do not have to be an inevitable part of aging. Research has shown that participating in falls related programs can prevent injuries. There are a variety of falls prevention programs that specialize in education and exercise that emphasize practical strategies to reduce risk and fear of falling. These programs offer health education, home modification tips, and exercise that can increase strength and balance along with activity levels in order to prevent falls. These factors can improve quality of life.

To learn more about various fall prevention programs visit: Evidence-based Falls Prevention Programs

To find assistance in locating an evidence-based program nearby, use the Evidence-Based Program Locator.

 ACL Grantees Supporting Older Adults with HIV

ACL grantees work hard across our organization to provide programs and services for people living with HIV. 

ACL Grantees Supporting Older Adults with HIV

Across the country, grantees work to implement programs that positively impact the well-being of older adults in their communities, including both directly and indirectly assisting populations of older adults living with HIV. Below are a few examples of the great work of some of these grantees.  Here are some examples specific to this population.

Project Open Hand (CA)

Project Open Hand Wellness Programs serve  medically tailored meals to clients living with HIV to support their medical treatment.  Meals are recommended by a RDN based on a nutritional assessment and a referral by a health care provider to address a medical diagnosis, symptoms, allergies, medication management, and side effects to ensure the best possible nutrition-related health outcomes.  The program offers fresh, healthy groceries available for weekly pickup for people and caregivers who can prepare meals.  For clients who are unable to travel, the Project Open Hand mobile van provides fresh groceries and frozen meals at mobile locations throughout San Francisco and Oakland, California.

Open Hand Atlanta (GA)

Open Hand Atlanta was founded in 1988, back in the early stages of the HIV epidemic. What started as cooking a few meals in a church kitchen quickly grew to an AIDS service organization. In 2000, Open Hand Atlanta expanded its mission to include seniors and those with other chronic conditions. However, people living with HIV/AIDS still account for one-third of the clients they serve each year. The main service to people living with HIV/AIDS is providing home-delivered, medically tailored meals.  For those who can cook their own food, Open Hand Atlanta provides “market baskets,” a grocery bag that contains shelf-stable items along with a bag each of fresh fruits and vegetables, which provides 14 meals a week. They also offer nutritional supplements to those in need of additional support and meals to dependents of the clients they serve living with HIV/AIDS. In 2020, Open Hand Atlanta delivered over 291,798 meals to 539 people living with HIV/AIDS. In addition to providing meal services, Open Hand Atlanta offers evidence-based CDSME programs for people living with HIV/AIDS.

Council for Jewish Elderly (Il)

The Council for Jewish Elderly (CJE) SeniorLife in Chicago is implementing three falls prevention programs supporting older adults who are HIV+, [SC(1)] low-income, minority, and/or LBGTQ in Chicago and New York City. CJE is working with existing social service agencies that have direct contact with people HIV+. Part of their grant work includes engaging a falls advisory steering committee (experts and members of the HIV community). and recruiting, training, and supporting partner staff and peer volunteers to lead the falls prevention programs. They conduct focus groups to gain insight into how to best market these programs and be culturally appropriate and inclusive in recruiting and delivery of programs.

Central Maine Area Agency on Aging (ME)

Healthy Living for ME is working with healthcare specialists to deliver the Positive Self-Management Program (PSMP) to individuals with HIV+ or AIDS. A key partner, MaineGeneral Health’s Horizon Program, supports identifying potential participants through their case managers. Healthy Living for ME also engages with SAGE Maine to bring awareness to the PSMP program.

For more information on the Topic 

      This section provides additional information to learn more about HIV.

More information on HIV/AIDS

HIV and Older Adults

Resources for Implementing Evidence-Based Programs

Programmatic Partnerships to Build in Your Area

To be effective at the state and local level, partnerships are essential.  Having a solid business partner who shares the passion for this work is most valuable.  Consider some of these partnerships:

  • Centers for independent living
  • Community centers or health programs focused on serving adults aging with HIV
  • Federally qualified health centers
  • Health departments administering the Ryan White HIV/AIDS program

Archive

Older Adults and HIV/AIDS Toolkit

In 2012, 40% of people living with an HIV diagnosis in the United States were over the age of 49. Yet older adults are often overlooked in the ongoing HIV/AIDS conversation. Developed for the National Aging Network and others interested in educating older adults, the Administration on Aging's HIV: Know the Risks. Get the Facts. Older Adults and HIV/AIDS Toolkit contains helpful resources and materials specifically designed to inform older adults about the risks of HIV/AIDS and to encourage older adults to know their status.

Toolkit contents:

Poster Series

The Graying of HIV/AIDS: Community Resources for the Aging Services Network Webinar

This webinar, The Graying of HIV/AIDS: Community Resources for the Aging Services Network, explores community programs and resources associated with positive aging and prevention. 

30th Anniversary of HIV/AIDS

This June 14, 2011, webinar, Positive Aging: HIV Turns 30, focuses on educating the Aging Network about HIV prevention and treatment specific to older adults.


Last modified on 07/17/2023


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