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Today, an estimated 1.1 million people are living with HIV in the U.S., and nearly half are aged 50 or older. Over the past 20 years, life expectancy for people living with HIV has risen dramatically thanks to advances in the science and understanding of HIV.

More time to live a fulfilling life is a wonderful thing. But as people living with HIV grow older, they may face new challenges, such as developing chronic diseases, taking multiple medications and finding that physical tasks once taken for granted are now more difficult. These challenges can happen to anyone as they grow older, but for people living with HIV, they’re occurring at younger ages compared to people without the virus.

Complications of Long-Term HIV Infection
Research has shown that HIV increases the risk for multiple health conditions. For example, studies have shown that the risk of cardiovascular disease among people living with HIV on antiretroviral therapy is twice that of those not living with HIV.

But why? There is no one reason, but it’s likely a mix of factors. HIV appears to cause chronic inflammation throughout the body, which is associated with many health conditions. Research suggests long-term inflammation may elevate cholesterol levels, which can harm blood vessels and the heart. Chronic inflammation has also been shown to be a risk factor for lung, lymphatic and pancreatic cancers.

Antiretroviral therapy may also play a role in the development of chronic diseases. Evidence has shown a link between HIV treatment and declines in bone mineral density, putting people living with HIV at higher risk for osteoporosis and bone fractures. Some antiretrovirals have contributed to the development of insulin resistance in people living with HIV, which can lead to diabetes, although chronic inflammation may also play a role in the increased risk. HIV treatment can also impact the brain. It is estimated that more than half of people living with HIV may experience difficulties with motor skills, memory and other cognitive functions.

“People living with HIV are at a higher risk for a number of age-associated conditions, so it’s critical that people are aware of and discuss these risks with their doctors,” said Dr. Kathleen Squires, global director, Scientific Affairs, Infectious Diseases, Merck Research Laboratories, and Professor of Medicine, Sidney Kimmel Medical College of Thomas Jefferson University. “More awareness around the impact of long-term HIV infection could lead to improved prevention, detection and management of these conditions in people living with HIV.”

Know your risk and speak up
As the population of people living with HIV continues to live longer, the burden of comorbidities will grow. That’s why it’s important to understand the risk and be proactive in maintaining a healthy lifestyle, including eating a balanced diet, exercising regularly and avoiding smoking.

For people living with HIV, advocating for their own health is equally important to ensure they receive the care they need. This is especially true in rural areas or in the U.S. deep south, where unfortunately, greater stigma and reduced access to medical care may make it harder to be engaged in HIV care.

If you or a loved one is living with HIV, talk to a doctor about the risk of age-associated chronic diseases. Be sure to share what other medicines you may be taking, including over-the-counter medications like herbal supplements or vitamins, which may interfere with the effectiveness of antiretroviral therapy. Health care professionals can work with you to create your own treatment plan based on your risk factors.