HIV and Africa's elderly: the problems and possibilities

Area of Science:

• Geriatric Medicine
• Infectious Diseases
• Public Health

Background:

• Demographic shifts in sub-Saharan Africa are leading to a growing population of older adults living with HIV.
• Antiretroviral therapy (ART) availability and coverage are increasing, contributing to longer lifespans for people with HIV.
• There is a significant knowledge gap regarding the specific health burdens and care needs of older Africans with HIV.

Purpose of the Study:

• To review the epidemiological data on HIV prevalence in older Africans.
• To examine progress and identify barriers in accessing HIV treatment and care for this demographic.
• To summarize unique clinical considerations for managing HIV in older Africans.

Main Methods:

• Systematic literature review of epidemiological data on HIV in older adults in sub-Saharan Africa.
• Analysis of current treatment access, progress, and associated barriers.
• Synthesis of clinical management considerations specific to older HIV-infected individuals.

Main Results:

• HIV prevalence is shifting to older age groups in sub-Saharan Africa.
• Access to treatment and care presents unique challenges for older Africans.
• Key clinical considerations include cardiovascular disease, neuropsychiatric conditions, oncologic illness, and musculoskeletal morbidity.

Conclusions:

• Improved understanding and management strategies are crucial for older Africans living with HIV.
• Prevention opportunities and technological advancements, such as polypills, may improve comorbidity management.
• This under-recognized, vulnerable group requires targeted interventions and further research.