Aging population at risk for new HIV infection

Include HIV in the differential diagnoses for patients aged 50 years and older.
Include HIV in the differential diagnoses for patients aged 50 years and older.

NEW ORLEANS — Primary care providers should include HIV and AIDS in the differential diagnoses for patients who are older than age 50 years, according to a poster presentation at the American Association of Nurse Practitioners 2015 meeting.

The average age of people in the United States with HIV/AIDS is increasing, said Debra A. Kosko, MN, RN, FNP-BC, clinical associate professor in the College of Nursing at East Carolina University in Greenville, North Carolina. Of the 1.2 million people with HIV in the United States, 26% are age 50 years or older. 

These older Americans are more likely than younger Americans to be diagnosed with HIV infection later in the course of the disease, to progress more quickly from HIV to AIDS, and to develop opportunistic infections. 

“There are people living much longer with HIV, so the chance of someone having an encounter as an older person with someone with HIV is greater. So now we're seeing new HIV infections increasing in older people,” Kosko said. 

She urged clinicians to consider the sexual activity of their older patients and the potential for a new HIV infection when they are working up other conditions. Providing an example from her own practice, Ms. Kosko related the case of an older patient who came in with dementia. A work-up determined that the condition was related to AIDS. 

Education is key to the issue of new HIV infection among older people. There is a particular need for primary care providers to become involved in educating not only older patients on the risk of unprotected sex in general but also patients with HIV about the risk of unprotected sex with HIV-negative partners, Ms. Kosko said.

Guidelines issued by the U.S. Preventive Services Task Force in 2013 recommend screening for HIV in all persons age 15 years to 65 years.

Reference

  1. Kosko DA. “The Aging of HIV.” Presented at: AANP 2015. June 9-14; New Orleans, Louisiana.

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