Editor’s note:
From July 23-26, 2023, the 12th International AIDS Society HIV Science Conference (IAS 2023) was held in Brisbane, Australia. In recent years, with the continuous advancement of modern antiretroviral therapy (ART), the life expectancy of people living with HIV (PLWH) has significantly improved. However, the accompanying aging issue of PLWH is becoming increasingly prominent, posing unprecedented challenges to HIV management. The quality of life and living conditions of elderly PLWH have become hot topics of discussion at this conference.
IAS President, Sharon Lewin
IAS current President Sharon Lewin emphasized, “The past 40 years of HIV research tells us that our HIV prevention and treatment work will be effective only when science, policy, and activism come together.” At this IAS conference, the concept of primary healthcare (PHC) for HIV, as highlighted in the World Health Organization (WHO) updated HIV management guidelines, was emphasized. The new guidelines suggest that the new HIV policy framework will help decision-makers optimize ongoing work and collaborations, advancing PHC and responses for specific disease groups, including elderly PLWH.
Currently, how is the quality of life for elderly PLWH, how to provide the best services for them, and how to formulate related intervention policies? These questions became special topics for exchange and discussion at the IAS conference. On the afternoon of July 25, in a session titled “Younger and Older: HIV across the Life Course,” researchers from the United States, Europe, and Africa presented their studies. Among them, Dr. Nestor Nuño from Spain’s National HIV/AIDS Plan shared a research report on the health-related quality of life and poverty risk for elderly PLWH in Spain. The aim of the study is to assist government departments in formulating proactive intervention policies targeting the elderly PLWH group.
In 2022, researchers conducted an online survey on self-management among PLWH patients to assess the health-related quality of life and poverty risk of elderly PLWH (≥50 years old) in Spain, specifically focusing on gender differences. Researchers used the standardized WHO QoL HIV BREF questionnaire to assess health-related quality of life and calculated poverty risk based on European guidelines from 2020. Statistical analyses included multifactor generalized linear models with potential confounding factors and robust estimates.
A total of 242 elderly HIV-infected patients participated in the questionnaire, including 187 males and 55 females. The average ages of the males and females were 57.1 years (SD=5.1 years) and 56.3 years (SD=4.0 years), respectively. In the WHO QoL HIV BREF survey, 84% of females scored lower than males. The survey results indicated that the health-related quality of life for elderly female PLWH was significantly reduced in five out of six areas compared to males, including physical health, psychological health, and level of independence. Additionally, elderly female PLWH were more likely to fall into poverty.
In summary, the results of this study support the need for policies targeting elderly PLWH, with a focus on improving their lifestyle and living conditions. This will provide comprehensive care for elderly patients and reduce gender inequality in health-related quality of life. Researchers stated that Spain will prioritize improving the material basis and living conditions upon which they rely, in its future policies and interventions for elderly PLWH.
References:
1. New WHO guidance on HIV viral suppression and scientific updates released at IAS 2023. [https://www.who.int/news/item/23-07-2023-new-who-guidance-on-hiv-viral-suppression-and-scientific-updates-released-at-ias-2023]
2. N. Nuño, A. Martínez, S. Martínez, et al. Assessing the health-related quality of life and risk of poverty of older people living with HIV in Spain: a cross-sectional study applying a gender perspective. IAS 2023 Abstract OAD0305.
