Ryan White and HIV/AIDS Aging Awareness Day

Content From: HIV.govPublished: September 14, 20203 min read


Cross-posted from TargetHIVExit Disclaimer

Note: The Health Resources and Services Administration (HRSA) is a key federal partner in the Ending the HIV Epidemic: Plan for America (EHE) initiative. As we approach National HIV/AIDS and Aging Awareness Day, we highlight HRSA’s efforts to serve the needs of older adults with HIV as the agency works towards the goals of the EHE initiative.

The HIV population in the United States is aging. This can be seen as a sign of success as people with HIV are living longer because they are engaged in care and benefiting from effective treatments. Consider these data from the HRSA Ryan White HIV/AIDS Program (RWHAP) fact sheet, Older Adult Clients: Ryan White HIV/AIDS Program, 2018

The aging trend has been underway for many years and is projected to continue. In 2018, RWHAP clients aged 55 and older accounted for 31% of all clients, up significantly from 16.6% in 2010. A large proportion of RWHAP clients (45-54 years old) are on the cusp of joining the 55+ age group.

Slides: RWHAP Clients Aged 50 Years and Older, 2018
Image credit:
Ryan White HIV/AIDS Program Clients, by Age Group, 2010 and 2018—United States and 3 Territories
Figure 1. Ryan White HIV/AIDS Program Clients, by Age Group, 2010 and 2017—United States and 3 Territories

The trend is likely to continue. By 2030, 64% of RWHAP clients are projected to be 50+. See the CROI 2019 poster Projected Growth and Needs of Aging People Living with HIV in HRSA’s Ryan White HIV/AIDS ProgramExit Disclaimer, presented by HRSA staff and summarized in the HIV.gov blog HRSA Analyzes Growing Ryan White Client Population Over 50 Years OldExit Disclaimer.

Proportion of Ryan White Clients 50 and Older, expected to grow from 42% in 2017 to 64% in 2030
Image credit:
Gagne S, Klein PW, Matosky M, Mills R, Redwood RC, Cheever LW. Projected Growth and Needs of Aging People Living with HIV in HRSA’s Ryan White HIV/AIDS Program. Poster presented at the 2019 Conference on Retroviruses and Opportunistic Infections.
Figure 2. The proportion of RWHAP clients aged 50 and older is projected to double from 2010 (31.7%) to 2030 (64.1%).

Care Needs of Older Persons with HIV

This year, HRSA convened two webinars to review the HIV care and treatment needs of older persons with HIV. Healthcare Needs of Adults with HIV who are Aging in the RWHAPExit Disclaimer reviewed medical and support service needs and emerging models of care. Psychosocial and Support Needs for People with HIV who are Aging in the Ryan White HIV/AIDS ProgramExit Disclaimer examined such issues as the impact of isolation and stigma.

Health Coverage and Medicare

As the HIV population ages, Medicare, federal health insurance for older Americans, is taking on a larger role. HRSA's ACE TA Center has developed a number of tools to help RWHAP programs navigate Medicare coverage. See the collection in The Basics of Medicare for Ryan White HIV/AIDS Program ClientsExit Disclaimer.

Clinical Insights: HIV Care for Older Persons with HIV

The Ryan White Clinical Conference has included multiple sessions on the clinical care needs of older individuals with HIV. At the 2020 Ryan White Clinical Conference were two sessionsExit Disclaimer: a plenary lecture, Managing Comorbidities in Older Adults with HIV Infection (August 10) and a breakout session, Screening and Management Issues in Older People With HIV Infection.

The AETC National Coordinating Resource Center has a collection of presentations and clinical tools on HIV care among persons over 50Exit Disclaimer. Examples include the National HIV CurriculumExit Disclaimer and its Topic: HIV in Older AdultsExit Disclaimer, with guidance on, for example, screening, treatment, and managing co-morbidities.