HIV and Aging: What to Know

Oct 20, 2022


Alto Pharmacy

Despite the misconception of HIV as an illness that primarily affects young people, nearly half of all those with HIV in the U.S. are age 50 and older. This is both a testament to the effectiveness of treatment, as many of these individuals were diagnosed at an earlier age, and a reminder that people of all ages can receive an HIV diagnosis.

As the HIV population ages, management of the condition continues to evolve, with different health challenges to navigate. Below, we highlight several important health considerations to be mindful of.

Stay on track with HIV treatment

Antiretroviral therapy (ART) has been the frontline treatment for HIV since 1995. It is a combination of medications that keep HIV from replicating, stopping the progression of the virus and preventing transmission.

When all medications are taken every day as prescribed, ART can help those with HIV maintain an undetectable viral load. As a result, more than half of all individuals living with HIV in the U.S. are not at risk of transmitting the virus to others.

Regular attendance at doctor’s appointments is an important part of proactively managing HIV. Your provider needs to monitor your body’s response to your individual ART protocol, testing bone, kidney, metabolic, cardiovascular, cognitive, and liver function. (Thanks to the variety of medication options, it is easy to make adjustments as needed if you experience side effects or don’t achieve the desired results.)

For older adults with HIV, ongoing monitoring and testing is especially important, as there is a greater possibility of side effects such as impaired cognitive function and bone health issues.

It is also important to closely monitor how ART interacts with other medications. As you age, you are more likely to be prescribed multiple medications to manage several conditions.

The importance of HIV testing

People of all ages should be regularly tested for HIV, since a diagnosis is possible at any age. Older individuals are less likely to be tested — and more likely to receive a late diagnosis — due to the following factors:

  • Shame or stigma

  • The misconception of HIV as exclusively a young person’s illness

  • The overlap between HIV symptoms and typical signs of aging

Remember that getting tested is the only way to know your HIV status. Continue to stay proactive about regular testing every year. Search for an HIV testing site near you.

Be proactive about preventative care

Older adults with HIV are more likely to also have health conditions associated with aging, including:

Here’s a quick look at how HIV intersects with several of these health issues.

Heart disease

The ongoing immune system activity and inflammation caused by HIV can contribute to plaque accumulation in blood vessels, a leading factor in the development of cardiovascular disease. Statins, a type of cholesterol-lowering medication, have been shown to lower the risk of heart disease in individuals with HIV.

To protect your heart health while living with HIV, stay on track with preventative care. Your provider should regularly check your cholesterol, blood pressure, and blood sugar. Additionally, maintain a heart-healthy lifestyle, with healthy habits like exercising regularly, eating a balanced diet, and refraining from smoking.


HIV has been linked to a greater risk of cancers including liver cancer, lung cancer, cervical cancer, and Hodgkin’s lymphoma. Ask your doctor about the recommended frequency of screenings for these types of cancer as well as others that are not related to HIV and AIDS.

Bone health

The gradual loss of bone mass is a normal part of aging. For those with osteoporosis, a condition that weakens bones, the changes are more pronounced. HIV can increase a person's risk of developing osteoporosis. (While osteoporosis disproportionately affects women, both men and women with HIV face an increased risk.)

A simple bone mineral density test, sometimes referred to as a DEXA scan, can identify bone health issues. This screening is recommended for all women over the age of 65 and all men over the age of 70. If you have HIV, you may need earlier and/or more frequent screening. Consult with your doctor about recommended frequency.

Cognitive health

Aging brings a risk of cognitive decline for anyone, regardless of health history. HIV has been linked to a faster decline in cognitive function. Though older individuals with HIV were once thought to have an elevated risk of dementia, the evolution of ART has helped lessen this possibility. However, a milder form of cognitive impairment called HIV-associated neurocognitive disorder (HAND) remains a health concern for older those with HIV.

Regular health exams should include screening for signs of cognitive issues including changes related to thinking or memory.

Seek connections and support

Loneliness and social isolation — factors in the development of physical health issues like dementia as well as mental health disorders — are more common among older adults. Older individuals with HIV should be even more proactive about monitoring mental health, as living with HIV at any age is linked to depression.

Make sure your doctor screens you regularly for depression and other mental health issues. If you have symptoms, ask about potential treatment options or a referral to a psychiatrist or psychologist. You may also want to explore additional resources such as virtual or in-person support groups for older adults with HIV.

Navigate HIV treatment with Alto by your side

Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with antiretroviral therapy. We will coordinate with your doctor and your insurance provider, if applicable, to ensure that you’re receiving the best option for your needs at the best price. To learn more, reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

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