Abstract
Objectives: New HIV diagnoses in persons aged > 50 years (hereafter ‘older persons’) are becoming more common; the clinical features and outcomes of these older individuals are poorly described. Methods: We conducted a retrospective cohort study of all new adult HIV diagnoses between October 1989 and December 2019 in southern Alberta, Canada. Differences in risk for HIV acquisition and screening, sociodemographic/clinical characteristics, and causes of death were compared between individuals younger and older than 50 years at the time of diagnosis. Results: New HIV diagnoses in persons > 50 years old increased from 7% in 1990 to 18% in 2019. Risk for HIV acquisition and screening reasons differed by age. Heterosexual sex (29%) was the greatest risk factor among older persons, contrasting with male same sex activity in younger persons (51%) (P < 0.001). Illness was the most common indication for testing in older persons (47%), whereas younger persons were more likely to have requested testing (34%) (P < 0.001). Relationship status differed, with 33% of older persons being married to an opposite sex partner versus 12% in younger persons (P < 0.001). Although older persons had a lower mean nadir CD4 count (132 cells/µL) than younger persons (181 cells/µL) (P < 0.001), 80% of deaths between 2010 and 2019 in the older group were attributable to non-AIDS-related causes versus 47% in younger patients. Since 2000, AIDS-related deaths and potential years of life lost have declined for both age groups. Conclusion: The increase in new HIV diagnoses in persons aged > 50 years in southern Alberta suggests that older individuals require customized approaches for optimizing HIV diagnosis and treatment.
Original language | English (US) |
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Pages (from-to) | 505-511 |
Number of pages | 7 |
Journal | HIV Medicine |
Volume | 21 |
Issue number | 8 |
DOIs | |
State | Published - Sep 1 2020 |
Keywords
- HIV
- diagnosis
- older adults
- potential years of life lost
- sociodemographic data
ASJC Scopus subject areas
- Health Policy
- Infectious Diseases
- Pharmacology (medical)