By Jesse Milan Jr., J.D
I have been living with HIV for 32 years. I was infected in my 20s. I’m aging with HIV. I am not alone.
One-third of the 1.1 million Americans living with HIV are 50 or older. Since amazing treatments have resulted in longer survival, soon 50 percent of all Americans with HIV will be 50-plus. Already in Maryland, where I live, 40 percent of PLWHA are now over age 50, and another 18 percent are 45-49. This is great news for anyone who remembers the terrible news reports about the deaths of young men from AIDS during the 1980s. But it is not the entire story: Aging healthy starts with knowledge. Nationally, 24 percent of Americans diagnosed with AIDS are 50 and over. Many of those are late diagnoses of people who did not even know they had HIV.
Thursday, Sept. 18, was National HIV/AIDS and Aging Awareness Day. It is mostly unknown among health-observance days. If you are old enough to remember the early days of the epidemic, it seems an oxymoron to speak of HIV/AIDS and aging in the same breath. So this awareness day informs people that with treatment, a full life with HIV is possible. Public awareness helps support our health as we face the challenges of aging with HIV.
Medically, financially and socially, HIV changes your life forever. Every prescription filled and swallowed daily, and every insurance bill, reminds me that I have a serious virus that never completely goes away. I must never forget to take my medications, because HIV reproduces itself rapidly or can mutate into a drug-resistant strain if it is not confronted constantly by treatments.
Powerful HIV treatments help me achieve a suppressed viral load. Achieving viral suppression prevents HIV from replicating and wreaking havoc on my immune system and causing me to progress to AIDS. It feels like a miracle—one I live with every day. Only 25 percent of Americans living with HIV have achieved viral suppression, a percentage that’s even lower among African Americans. Too many people have difficulty getting or remaining on treatments that can help them reach old age.
Aging healthy with HIV requires vigilance. HIV-fighting medications must interact effectively with the other medications that many people over age 50 take. Every three to six months I must have blood drawn to check on the virus. And I see my doctor several times a year to monitor my lymph nodes and overall condition.
In the meantime, I have the same health concerns as my uninfected baby boomer peers. Aging is hard on all of us, but those of us growing older with HIV must work harder to remain healthy. Eating nutritious foods and exercising, as well as reducing stress, alcohol consumption and smoking, are critical to helping HIV medications work. But even with treatments, HIV still exists in the body, where it finds places and organs to reside. And some experts report that HIV can accelerate normal aging processes and even cause dementia.
I age also with memories of friends who died and with uncertainties about my next blood test. I wonder: Are my treatments still working? Is my viral load still suppressed? Is my immune system’s CD4 count still high enough to prevent me from developing an AIDS-defining illness? These worries alone can age you.
Nonetheless, treatments make a full life with HIV possible—a life I am grateful to live.
Each year, 15,000 Americans still die from AIDS. Too many never make it to 50. And the stigma of HIV is persistent; you never know how people will respond when told you have HIV. And you’re never too old for their response to affect you. I count among my blessings the family and friends who support me.
People over 50 are still sexual. So while pregnancy may not be a concern, HIV should be. Protect yourself from HIV and know your HIV status and your partner’s. Discuss your sexual activity with your health-care providers so they can evaluate you health, evaluate any possible symptoms and offer you an HIV test if appropriate. And should you learn that you are HIV positive, create your own long future by getting on anti-HIV treatment.
HIV has been part of America since 1981. New treatment advances and the Affordable Care Act together raise the prospect of ending the HIV/AIDS epidemic in this country. But America has far to go. I pray that none of us aging with HIV ever dies of AIDS. Your awareness surely helps.
Jesse Milan Jr., J.D., lives in Ellicott City, Md. He is chair emeritus of The Black AIDS Institute and a Fellow at the Altarum Institute.