Similar to trends reported by the Centers for Disease Control and Prevention in the United States, health officials in the United Kingdom are reporting that a growing number of patients with HIV — more than 15% — are adults aged 55 and older.
“Almost half (48% or 40,834) of all people seen for HIV care in 2014 were aged 45 and over, up from 25% over the past decade, whilst those aged 55 or over and 65 or over now account for 15%, and 4% respectively,” according to a report issued this week by Public Health England. The report’s authors wrote that the 55 and over population has a higher incidence of comorbidities and complications that highlight the need for integrated care.
In the United Kingdom, 85,489 patients were seen for HIV during 2014. There were 6151 new cases, up slightly from the previous year, which the researchers attributed to continued improvement in treatment — as people with HIV live longer now with expanded treatment options — as well as continued transmission.
The researchers noted an increase in infections in men who have sex with men (2860 in 2010 to 3360 in 2014), but they noted heterosexual sex-acquired infections decreased from 3440 in 2010 to 2490 in 2014.
The report indicates that the majority of newly-diagnosed patients in the United Kingdom are taking antiretroviral (ART) medications.
The report’s authors noted that late diagnosis continues to be a problem. “Two out of five people newly diagnosed with HIV in 2014 had ‘late stage’ HIV, evidenced by a CD4 count below 350, and this remains stubbornly and unacceptably high (56% in 2005),” according to the report.
Data from the Centers for Disease Control and Prevention in the United States indicate that 24%, or 8,575 of patients with HIV in 2013 of the 47,352 HIV diagnoses were in people age 50 and older, with the greatest number of cases occurring in 50-54 year olds. African Americans accounted for the largest number of those cases at an incidence of 59.3 per 100,000. The rate for Latinos/Hispanics was 23.3 and for whites 8.7.
Earlier diagnosis results in better prognosis, so testing is key, especially in older populations, many of whom believe that HIV is not an issue for their generation, according to the report’s authors.
Clinicians should educate older patients, many of whom are divorced or widowed, in safe sex practices to lower HIV transmission rates.
1. Skingsley A, Kirwan P, Yin Z, et al. HIV new diagnoses, treatment and care in the UK 2015 report: data to end 2014. Public Health England, London. Published October 2015. Accessed October 26, 2015.