Aging with HIV

Summary

• Advances in HIV treatment mean that people living with HIV who are diagnosed early and start and stay on antiretroviral therapy (ART) can keep the virus suppressed and live a long and healthy life.
• Older Americans are more likely than younger Americans to be diagnosed with HIV late in the course of their disease, meaning they get a late start receiving the benefits of HIV treatment.
• It is important for older people living with HIV to get linked to HIV care and have access to mental health and other support services to help them stay healthy and remain engaged in HIV care.

Growing Older with HIV

Today, advances in HIV treatment mean that people living with HIV who are diagnosed early and start and stay on antiretroviral therapy (ART) can keep the virus suppressed and live a long and healthy life. For this reason, more than half of people diagnosed with HIV in the United States are age 50 and older. Many of them have been living with HIV for many years; others were diagnosed with HIV later in life.

That’s a significant change from the early years of the epidemic when people who were diagnosed with HIV or AIDS could expect to live only 1 to 2 years after their diagnosis. This meant that the issues of aging were not a major focus for people living with HIV disease.

According to the latest data from the Centers for Disease Control and Prevention (CDC), of the over 1.1 million people living with diagnosed HIV in the United States in 2023, approximately 54% (597,296) were aged 50 and up.

In 2024, people over age 50 living with HIV made up nearly half of the over half a million clients served by the Ryan White HIV/AIDS Program (RWHAP). However, according to a 2023 CDC study, people who were diagnosed at age 65 and older were the lowest percentage of people achieving viral suppression.

Despite people living longer, healthier lives with ART and lifestyle changes, older adults living with HIV still experience unique challenges as they age.

Health Issues and Aging with HIV

Aging affects everyone, regardless of your HIV status. People aging with HIV share many of the same health concerns as the general population age 50 and older, including:

• Multiple chronic diseases or conditions,
• The use of multiple medications,
• Changes in physical and cognitive abilities, and
• Increased stress.

In addition, while effective HIV treatment has decreased the likelihood of AIDS-defining illnesses among people aging with HIV, many HIV-associated non-AIDS conditions occur frequently in older persons living with HIV, such as cardiovascular disease, diabetes, renal disease, and cancer. These other health issues of concern are likely related to a number of interacting factors, including chronic inflammation caused by HIV. Having these additional conditions may also mean having to take additional medications that may have adverse side effects or interact with your HIV medication. In addition to following your HIV treatment regimen, talk to your doctor about how you can prevent or reduce symptoms of other conditions. HIV and its treatment can also have effects on the brain. Researchers estimate that between 30% and 50% of people living with HIV have HIV-Associated Neurocognitive Disorder (HAND), a spectrum of cognitive, motor, and/or mood disorders categorized into three levels: asymptomatic, mild, and HIV-associated dementia. Researchers are studying how HIV and its treatment affect the brain, including the effects on older people living with HIV.

Certain medications, like statins used to treat cardiovascular conditions, can be used in addition to your HIV treatment regimen to help treat or prevent comorbidities. Always speak with your doctor about the possibility of adding or changing medications.

National HIV/AIDS and Aging Awareness Day

Led by the AIDS Institute, National HIV/AIDS and Aging Awareness Day (NHAAD) is observed each year on September 18 to focus on the increasing number of people who, because of major advancements in HIV treatment, are living long, full lives with HIV.

HIV Long-Term Survivors Awareness Day

HIV Long-Term Survivors Awareness Day is observed annually on June 5 to recognize the resilience of the long-term survivors and the need to continue addressing both the physical and mental challenges to their well-being due to decades of successful disease management.

Late HIV Diagnosis Among Older Adults Living with HIV

Older Americans are more likely than younger Americans to be diagnosed with HIV late in the course of their disease, meaning they get a late start receiving the benefits of HIV treatment and possibly incur more damage to their immune system. This can lead to poorer outcomes and shorter survival after an HIV diagnosis. Late diagnoses can occur because health care providers may not always test older people for HIV infection. Also, older people may mistake HIV symptoms for signs of normal aging and don’t consider HIV as a possible cause they should discuss with their provider.

According to a CDC report published in 2024, 34% of people age 65 and older in the United States have late-stage HIV diagnosis.

Older Adults, COVID-19, and Other Respiratory Viruses

Older adults and people of any age who have serious underlying medical conditions are at higher risk of getting very sick from respiratory viruses such as COVID-19, flu, and respiratory syncytial virus (RSV). This includes people who have weakened immune systems. The risk for people living with HIV getting very sick from respiratory viruses is greatest in people with a low CD4 cell count and people not on effective HIV treatment.

The risk of getting very sick from respiratory viruses also increases with age. For example, people who are 85 years old are at a substantially higher risk of getting very sick than people who are 65 years old.

Read CDC’s information about how you can protect yourself from COVID-19, flu, and RSV.

The Importance of Support Services for Older Adults Living with HIV

Living with HIV presents certain challenges, no matter your age. But older people living with HIV may face different issues than their younger counterparts, including greater social isolation and loneliness. Shame is also a particular concern among older people living with HIV. Stigma, shame, and embarrassment negatively affect people’s quality of life, self-image, and behaviors, and may prevent them from disclosing their HIV status or seeking the health care or social services that many aging adults may require.

Therefore, it is important for older people living with HIV to get linked to HIV care and have access to mental health and other support services to help them stay healthy and remain engaged in HIV care. You can find support services through your health care provider, your local community center, or an HIV service organization. Or use the HIV Services Locator to find services near you.

Sources:

CDC. HIV Surveillance Report Tables, 2023, Diagnoses, Deaths, and Prevalence of HIV in the United States and 6 Territories and Freely Associated States, 2023. HIV diagnoses, deaths, and prevalence: 2025 update. 2025.

HRSA. Section 1: National-Level Data: Client Characteristics, Ryan White HIV/AIDS Program Annual Data Report 2024. 2025.

CDC. Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data, 2023. National HIV prevention and care objectives: 2025 update. 2025.

NIH. Special populations: HIV and the older person. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. Clinical Info. 2024.

Elendu, C., Aguocha, C. M., Okeke, C. V., Okoro, C. B., & Peterson, J. C. HIV-Related Neurocognitive Disorders: Diagnosis, treatment, and mental health implications: A review. Medicine, 102(43), e35652. 2023.

HHS. Statin Therapy as Primary Prevention of Atherosclerotic Cardiovascular Disease in People with HIV. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV. Department of Health and Human Services. 2025.

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention. Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data—United States and 6 Territories and Freely Associated States, 2022. HIV Surveillance Supplemental Report, Vol. 29, No. 2. Centers for Disease Control and Prevention. 2024.