Part 1: #AgeingHIV: Glory days, (s)he ain’t never had

Posted by Share-Net NL on April 18, 2016 at 9:01 am

Let’s face it, in today’s society there is no such thing as growing up gracefully. Most individuals dread getting old and its perceived negative impact on life. But there was a time in the 80’s that people would do anything to live longer just for one more day.

These people were infected with HIV and were told they would die within months. Some survived and Maxime Journiac is one of the “lucky” Long Term Survivors. Like him many have to deal with “Survivors Guilt” and from a societal perspective it is expected for them to adapt to staying alive and remain happy. Maxime and other like him want to live but asks what price and under which condition.

Through the looking glass
In a 2 part series on ageing with HIV, we will start with the short comings on sexual and reproductive health and rights. Then, when we are a little bit older, in part 2 we become wiser with some possible positive approaches to care.

Let’s start with the first myth: Ageing with HIV does not mean being a Long Term survivor. Recent data from 2014 by the ECDC showed that Europe has almost 30.000 new diagnoses in the EU/EEA with people of an age of 50 and over.  This is likely just the tip of a bigger iceberg and it is a great indicator of ageism in prevention work. Yes kids, Mom and Dad will have sex when you leave the house and mature gays can have up to 12 or more active swinging partners. This was made clear by the Dutch documentary “69: Love, Sex, Senior”

Sex is healthy for the ageing population but the transmission route of HIV for this population is unknown. Well, it is now known that it is transmitted by having an active sexlife.

Let’s talk about sex!
Adolescents and young mature people have a higher uptake on HIV tests than the ageing population. Those who take an active role in testing and overcome the stigma of being an active 55+ year old in an STI clinic, will often frequently discover that the person is a late presenter of HIV. This will have a big impact on physical health.

With low CD4 count and multi-morbidities, it will affect the ageing person’s ability to be productive in society. Isolation is another outcome for an ageing late presenter of HIV and it will have an impact on their sexlife.

Sexlife as an ageing woman isn’t simple either, as Shema Tariq, involved with the PRIME study finds out. It focusses on positive women and the menopause. Menopause for positive women starts at earlier age and with increased symptoms that are under recognized.

Studies on the use of hormone replacement treatment during the menopause has little data on its effects with HIV and an ageing person. In a general sense, lots more awareness is needed in a healthcare setting on this issue.

There is a pill for that
Quality of life should be better when ageing populations are on ARV treatment but little is known about pharmacology and drug-drug interactions. While people living with HIV biologically age at different rates, it has an impact on pharmacokinetics according to Catia Mazolini from the University Hospital Basel. It can affect the efficacy of or sensibility of drug treatment.

Good intentioned healthcare providers can go down the path of mistaking side effects for disease. This leads to new prescribed drugs for the ageing person and it can cause more adverse drug reactions with more side effects.

Or for those healthcare providers that believe people don’t have an immortal life, they can think it is a waste of time to treat serious symptoms like pain because the person is old and going to die soon.

Hello, how are we feeling today?
There is a way out of these types of reactions, by reaching out to the ageing person with HIV. Let the person responsibly decide.

When the ageing person living with HIV takes center stage, it is often the case that the person is spoken to like a 5 year old. This happens quite frequently in healthcare settings. The patient has liver spots, wrinkles and looks frail. Assumptions are made that the person lacks the capacity to understand complex issues. That is an example of ageism.

But there is a truth in that statement for an ageing person. It is complex to manage 5 or more specialist and be an expert on HIV. Because not all specialists are aware of HIV and the interactions with other morbidities.

So how to improve life as an ageing positive person and reduce the burden of care?

Find out in next article called:  “ #AgeingHIV: When I’m 64 “

About the Author:

Robin is positively living with HIV since 2006 and started to run around the sun since 1983. With a background in applied science and communication, Robin is active with HIV in The Netherlands since his 23rd pass around the sun. He was a former board member for Poz&Proud, the gay movement of the Dutch HIV association, where he supported and advocated for those living with HCV. Currently, he keeps himself busy as a coordinator for the Dutch Brabant province that provides services for local PLHIV and HIV positive (undocumented) migrants, consults a Dutch sexual health clinic in The Hague, organises ‘The International Aids Candlelight Memorial’ and supports the communications team of GNP+.

With a keen interest in social histories and human dynamics, Robin is convinced that life isn’t a lifestyle and the best way to know what suits him is to sample everything. 

Мен бостандығы өмір сүріп (Kazach for: “I live in freedom”).

Author: Robin Irwin
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