HIV and Specific Populations

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HIV and Older Adults

Last Reviewed: April 8, 2019

Key Points

  • According to the Centers for Disease Control and Prevention (CDC), in 2015, an estimated 47% of Americans living with diagnosed HIV were aged 50 and older.
  • Many HIV risk factors are the same for adults of any age, but older people are less likely to get tested for HIV.
  • Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone with HIV. Life-long treatment with HIV medicines helps people with HIV live longer, healthier lives.
  • Many older adults have conditions such as heart disease or diabetes that can complicate HIV treatment.

Does HIV affect older adults?

Yes. Anyone can get HIV, including older adults. According to the Centers for Disease Control and Prevention (CDC), in 2015, an estimated 47% of Americans living with diagnosed HIV were aged 50 and older.

The number of older adults living with HIV is increasing for the following reasons:
  • Many people diagnosed with HIV at a younger age are growing older. Life-long treatment with HIV medicines (called antiretroviral therapy or ART) is helping these people live longer, healthier lives.
  • Thousands of older people are newly diagnosed with HIV every year.

Are the risk factors for HIV the same for older adults?

Many risk factors for HIV are the same for adults of any age. But like many younger people, older adults may not be aware of their HIV risk factors.

In the United States, HIV is spread mainly by:

  • Having anal or vaginal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV
  • Sharing injection drug equipment (works), such as needles, with someone who has HIV

Some age-related factors can put older adults at risk for HIV infection. For example, age-related thinning and dryness of the vagina may increase the risk of HIV infection in older women. In addition, women who are no longer concerned about pregnancy may be less likely to use a condom during sex.

Talk to your health care provider about your risk of HIV infection and ways to reduce your risk.

Should older adults get tested for HIV?

CDC recommends that everyone 13 to 64 years old get tested for HIV at least once as part of routine health care and that people at higher risk of infection get tested more often. Your health care provider may recommend HIV testing if you are over 64 and at risk for HIV infection.

For several reasons, older people are less likely to get tested for HIV:

  • Health care providers may not always think to test older adults for HIV.
  • Some older people may be embarrassed or afraid to be tested for HIV.
  • In older adults, signs of HIV infection may be mistaken for symptoms of aging or of age-related conditions. Consequently, testing to diagnose the condition may not include HIV testing.

For these reasons, HIV is more likely to be diagnosed at an advanced stage in many older adults. When HIV is diagnosed late, this means that treatment with ART starts late too.

Ask your health care provider whether HIV testing is right for you. Use these questions from healthfinder.gov to start the conversation: HIV Testing: Questions for the doctor.

Is HIV treatment the same for older adults?

Treatment with HIV medicines is recommended for everyone with HIV. There are no specific HIV treatment recommendations for older adults. Just like for anyone with HIV, the choice of an HIV treatment regimen for an older adult is based on the person’s individual needs.

However, age-related factors can complicate HIV treatment in older adults.
  • Liver and kidney functions decline with age. This decline may make it harder for the body to process HIV medicines and increase the risk of side effects.
  • Older adults with HIV may have other conditions, like diabetes and heart disease, that can make it more difficult to manage HIV infection. In addition, HIV may affect the aging process and increase the risk of age-related conditions such as dementia, bone loss, and some cancers. Taking HIV medicines and medicines for other conditions at the same time may increase the risk of drug interactions and side effects.
  • The immune system may not recover as well or as quickly in older adults taking HIV medicines as it does in younger people.

Where can I find more information about HIV and aging?

Click on the links below to find more information about HIV and aging. This fact sheet is based on information from these sources:

From CDC:

From the Department of Health and Human Services:

From the National Institute on Aging (NIA):

Need Help?

  • Call 1-800-448-0440
  • (1 p.m. to 4 p.m. ET)
  • Send us an email