Inaugural NAPWA Think Tank: HIV and Ageing

NAPWA's inaugural Think Tank was held in Sydney on 24th June 2010, and aimed to:

• Define ageing in relation to HIV, including clinical [1]Pertaining to or founded on observation and treatment of participants, as distinguished from theoretical or basic science. and psycho/social dimensions.
• Collate and share evidence about HIV and ageing.
• Explore likely ramifications for individual PLHIV [2]Person (or people) Living with HIV. This term is now preferred over the older PLWHA., the HIV community, mainstream aged care and health care sectors.
• Develop a workplan for the HIV sector toward future work on HIV and ageing.

About 60 attendees heard 10 speakers present from diverse perspectives, including:
David Menadue and Ross Duffin from NAPWA gave personal and community perspectives on ageing with HIV. Both have advocated giving more attention to the issue of ageing among PLHIV.
Dr Edwina Wright of the Alfred Hospital gave a comprehensive distillation of current scientific research and clinical thinking about ageing and HIV. She challenged the group to think about lifestyle issues at play in preventable illnesses and the role of community based health promotion.
Associate Professor John Murray, NCHECR [3]National Centre in HIV Epidemiology and Clinical Research. Based at the University of NSW in Sydney, NCHECR is one of Australia's leading medical research centres and is recognised internationally as a leader in the field of research into HIV/AIDS and viral hepatitis. , gave a presentation The ageing of the HIV epidemic in Australia: how old, how well, and where are they? One implication of his work was that older men and women diagnosed with HIV infection have been undiagnosed longer than their corresponding younger cohort [4]In epidemiology, a group of individuals with some characteristics in common. A cohort study is a special kind of clinical trial which looks at a treatment or treatment strategy in a cohort of people. and are more susceptible to AIDS.
James Jansson and Associate Professor David Wilson, NCHECR, presented a paper Modelling the Expected HIV Population and Related Health Outcomes. In it they posited that PLHIV are both living longer as a result of antiretroviral [5]A medication or other substance which is active against retroviruses such as HIV. therapy and at increased risk of developing cancers, cardiovascular disease, mental health disorders, and other co-morbidities, as they age. They argued that increasingly complex health needs among PLHIV in Australia will have significant implications for the health workforce in the coming decades.
Dr Jeffrey Grierson, ARCSHS [6]Australian Research Centre in Sex, Health and Society, part of La Trobe University in Melbourne. For further information see http://www.latrobe.edu.au/arcshs/ [7]., presented findings from the Futures Study, which included that older PLHIV experience high rates of non-HIV related morbidities. He also presented data on social support among the older group, reporting that as people age they rely more heavily on doctors for support.
Following the researchers, three people from the partnership in Queensland, Simon O’Connor (QPP), Paul Martin (QAHC) and Gary Boddy (Queensland Health) detailed efforts occurring there to better understand the nature and implications of the ageing PLHIV population, particularly pertinent as John Murray had earlier provided compelling evidence of a migration to Queensland among HIV positive people, as well as the general population.
Finally, Peter Thoms of BGF gave a service provider’s perspective on the complexities that arise for some PLHIV as they age, a reminder of challenges that lie ahead as the overall population ages.
In the afternoon, attendees formed three discussion groups to examine fictional case-studies focussing on psycho-social, policy or clinical issues, Professor John de Wit summarising outcomes. The various themes were sorted into implications for services, PLHIV and planning needs to improve future outcomes, laying the ground for NAPWA to develop future activities.

Feedback on the event was overwhelmingly positive, and NAPWA will now develop various projects in this area over the coming year: watch this website!