ASHM 2008: Older and HIV+

HIV and ageing has generated a lot of interest recently. The advent of highly active antiretroviral [1]A medication or other substance which is active against retroviruses such as HIV. therapy means that we now have HIV-positive people living longer, many will survive into old age.

In recognition that we are starting to see a 'greying' of the epidemic, the ASHM [2]Australasian Society for HIV Medicine. The peak Australasian organisation representing the medical and health sector in HIV/AIDS and related areas. conference this year presented a plenary session on HIV and ageing and there was an unprecedented coverage of material around the issue.

In the plenary session Professor Bruce Brew talked about neuro-degeneration and the effects of ageing on the brain in HAART [3]Highly Active AntiRetroviral Therapy ??? aggressive treatment of HIV infection using several different drugs together. treated patients and how this is becoming an increasing concern. Amongst many points he mentioned the significance of having effective drugs that will penetrate the central nervous system to reduce the development cognitive impairment or dementia.

In his presentation Dr David Nolan from Perth acknowledged that long-term HIV treatment now incorporates an increased awareness of age-associated conditions such as cardiovascular and metabolic diseases, osteoporosis, cognitive decline, and the risk of malignancy.

Professor Marion Pitts from ARCSHS [4]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/ [5]. presented a paper on Growing old disgracefully with HIV. She said “ageing brings with it new challenges that may be related to the ageing process itself, to living longer with the virus [6]A small infective organism which is incapable of reproducing outside a host cell., and living longer on treatments. We simply do not know what the effects of HIV will be in the very long term, there is some evidence of premature ageing associated with HIV, but there are also indications that older HIV-positive people actually have better well-being.

Kathy Triffit from Positive Life NSW presented a very interesting paper titled Getting on with it again, which is also the name of a booklet [7] that they have developed based on stories and interviews and shares some strategies for change and enhancing life. Her paper examined activities undertaken by Positive Life in its policy work, group discussions, peer support and systemic advocacy with people who are living longer with HIV. Kathy noted that by incorporating and sharing personal strategies for change and enhancing quality-of-life, we promote the capacity at a community level to negotiate the challenges of living longer with HIV. Other activities about ageing within Positive Life were presented including material by Rob Lake. He noted that peer-support, social opportunities and engagement are key requests from older gay men living with HIV. “One of the lessons for us is to recognise diverse needs, seek as much evidence as possible about those needs and refine services to meet them.”

Trish Langdon, Executive Director of the West Australian AIDS Council said in a press release from the conference that “many aged care workers have not had much experience dealing with HIV and AIDS.” She said, “much needs to be done to make sure that people with the virus, who are having to deal with a complex range of health issues, can get the level of care they need. This is going to be quite challenging for the next 5 to 10 years.” It was clear from the conference that there is a great deal of work ahead of us in dealing with HIV and ageing in the future.

John Daye is NAPWA Co-Convenor of Health, Treatments and Research.