Money, Pills, and Isolation: Survey Reveals Concerns of Aging Patients With HIV

People with HIV are living longer than ever at present time, raising quality of life concerns about later stage medical and psychological comorbidities.

Unsurprisingly, in a new survey presented at the International AIDS Society (IAS) AIDS 2020 Virtual Sessions, older adults living with HIV expressed a variety of unmet financial and emotional needs when asked about their experience with the aging process.

The CORE healthy aging initiative 2.0 (CHAI 2.0), a needs assessment survey, was designed to gather information on the challenges faced by patients at the CORE center in Chicago who are living with HIV at 60 years of age or older.

From February-December 2019, the CHAI 2.0 assessment survey was distributed by peer navigators during clinic visits. A total of 331 people living with HIV completed the CHAI 2.0 baseline survey, and 415 were surveyed in total.

The median age of patients was 64 years; 70% and 30% were female. Ethnic demographics were 83% African American, 9% white and 6% Hispanic/Latino.

The investigators assessed when the patients had been diagnosed with HIV, and how many had undetectable viral loads. There was a 79% majority of patients who had been diagnosed with HIV in the previous 10 years and 82% reported undetectable viral loads.

In a reflection of potential polypharmacy, 24% of older patients reported taking >6 medications daily. Nearly 40% of patients smoked as of the time of study, 50% had hypertension, depression was found among 30% of participants, hyperlipidemia among 25%, diabetes in 20%, and kidney disease in 14%.

In the preceding year, 30% of participants had a fall and 55% lived alone. Concerningly, 41% reported feeling lonely sometimes in the last month. The top 5 concerns expressed in the patient population were money concerns (41%), living with HIV (37%), other medical concerns (30%), housing (29%) and who will care for the patient in old age (24%).

Other concerns expressed included memory issues (23%), stigma (21%), retirement planning (18%), loneliness (14%), finding a partner (14%), sexual health (14%) and mental health concerns (13%). Reflecting this fear of stigma and desire for privacy, 22% of respondents reported they had not disclosed their HIV status to any person outside of clinic staff.

“Among older, predominantly African American people with HIV, 55% lived alone. The interplay of polypharmacy, social isolation, and comorbidities increase the risk of falls and other adverse outcomes,” authors of the presentation explained, urging more action to meet the population’s needs.