Substance Use Among Older People Living With HIV: Challenges for Health Care Providers.

Sherry Deren,Madeline Naegle,Vincent Guilamo-Ramos,Benjamin H Han,Victoria Vaughan Dickson,Bei Wu,Danielle C Ompad,Tara Cortes,Stephen Karpiak

doi:10.3389/fpubh.2019.00094

Abstract

Older people living with HIV (OPLWH) have higher rates of substance use (tobacco, alcohol, and other drugs) than their HIV-negative peers. Addressing health care needs of OPLWH who use substances is more challenging than for those who do not: they are highly impacted by comorbid conditions, substance use can interact with other medications (including antiretroviral therapy-ART) and reduce their effectiveness, and substance use has been associated with reduced adherence to ART and increased risky behaviors (including sexual risks). People who use substances also suffer disparities along the HIV continuum of care, resulting in lower viral suppression rates and poorer health outcomes. They are especially impacted by stigma and stress, which have implications for HIV treatment and care. Recommendations for health care providers working with OPLWH who use substances include: (1) the need to screen and refer for multiple associated conditions, and (2) training/continuing education to enhance care management and maximize health outcomes.

Highlights

As treatments for HIV have improved, the population of older people living with HIV (OPLWH) has increased
As the population of those who are HIV-infected continues to age, there is a need for health care providers, especially those working with geriatric populations, to become knowledgeable about the impact of substance use on Older people living with HIV (OPLWH) so that their health care needs are optimally identified and addressed
The article will provide an overview of substance use prevalence among OPLWH who are aged 50 and older and many of the comorbidities and associated challenges encountered in managing their health needs

Summary

Introduction

As treatments for HIV have improved, the population of older people living with HIV (OPLWH) has increased. As the population of those who are HIV-infected continues to age, there is a need for health care providers, especially those working with geriatric populations, to become knowledgeable about the impact of substance use on OPLWH so that their health care needs are optimally identified and addressed.

Results

Conclusion