Nearly a month after the third annual National HIV/AIDS and Aging Awareness Day, San Francisco AIDS Foundation and other Bay Area organizations will offer HIVision Forum: HIV and Aging: Now What? on October 13 to explore what it means to get older with HIV. Free and open to the public, the forum’s panel of experts will address the challenges that older individuals living with HIV and AIDS face when it comes to the medical, emotional, and social aspects of their lives. The forum will also address how communities, and healthcare and service providers can help.

A&U spoke with one of the panelists, Michael D. Siever, Ph.D., Director of Behavioral Health Services, San Francisco AIDS Foundation, via e-mail about the upcoming forum.

A&U: Was there a specific impetus for creating this forum theme?
Michael D. Siever: Thanks to better HIV treatments—and years of hard work by HIV treatment advocates—people with HIV are now living long enough to get old! As the leading HIV/AIDS organization in San Francisco, we want to help ensure that the city’s researchers, clinicians, policy-makers, service providers, and community members are prepared to meet the needs of this growing population.

The press release mentioned a need to address unique medical, emotional, and social challenges. What are some of these challenges that individuals are facing as they are living longer with HIV?
People with HIV appear to be experiencing medical conditions like atherosclerosis and neurocognitive impairment many years earlier than people who don’t have the virus. It’s not entirely clear why, although researchers are learning that chronic inflammation plays a significant role. Research is underway to better unpack how the interaction of HIV disease, antiretroviral and other medications, and the aging process itself contributes to these health outcomes.

In terms of social and emotional challenges, HIV and older age both carry a lot of stigma in our society; put the two together, and older people living with HIV can feel extremely isolated and have difficulty finding adequate care and support. Add to that equation the common misconception that people don’t have sex in later age, and you lose opportunities to talk to older people—HIV positive and HIV negative alike—about HIV prevention, as well.

We’ve just marked our third annual National HIV/AIDS and Aging Awareness Day. How might be or how are strategies tailored to reach out to individuals over fifty with a prevention and/or testing message?
In many ways, we here at SFAF and other AIDS agencies have already been dealing with these issues as people living with HIV have aged. A large proportion of the participants in our various programs and services are themselves now in the 40s, 50s, even 60s and we have been adapting our outreach and programming all along as this has happened.

Another factor is that the average age of people newly infected with HIV here in San Francisco continues to be late 30s so this is a reality that we have dealing with for a long time. These factors in addition to the fact that eighty percent or more new HIV infections in San Francisco continue to be among gay men and other men who have sex with men have meant that most of our outreach and intervention efforts are designed to reaching gay men throughout the age spectrum not just younger men.

How can service providers help to improve services and quality of life for those over fifty living with HIV/AIDS?
First of all, to be aware of the issues and concerns with HIV and aging. This is the reason for this forum – so people can better understand the issues and concerns and learn what we do and do not know. This is an area in which the research is in some ways just catching up with reality. But we want people to know what we have learned about the interaction of HIV, HIV meds, and the aging process and what are the questions that still need further research to get closer to the answers (or to at least refine the questions).

Anything else you wanted to cover?
That this is a time to both celebrate that so many are now living long and relatively healthy lives with HIV but that there are also new issues and concerns that have arisen as people with HIV have been living longer. And finally to invite folks to the forum and those that are not local to check the SFAF website (sfaf.org) afterward to check out what was said in the forum.

HIV and Aging: Now What? will convene on October 13, 5:30–7:30 p.m. (reception to follow), at Delancey Street Foundation, Screening Room, 600 Embarcadero, San Francisco, California. For more information, visit www.sfaf.org.