Addressing challenges of aging with HIV requires team approach

  • Nearly half of the people living with HIV/AIDS in the nation in 2015 were age 50 and older, according to estimates from the Centers for Disease Control and Prevention. Some had recently been diagnosed, but many had been living for decades with the virus. When the HIV epidemic first began in this country in the early 1980s, the average life expectancy after diagnosis was 1 to 2 years. Since then, HIV medications called antiretroviral therapy (ART) have helped HIV-positive people live longer and healthier lives. However, this population faces unique problems as they get older. Today is National HIV/AIDS and Aging Awareness Day and this is a time to look at the challenges of aging and being HIV-positive.

    Researchers are not sure of the exact cause, but people with HIV can experience accelerated aging. They may develop age-related conditions such as cardiovascular disease, diabetes, certain cancers, kidney and liver disease, osteoporosis and cognitive impairment decades ahead of their HIV-negative counterparts. As they age and/or become more ill, HIV-positive older adults may find themselves needing the support of long-term care facilities much earlier than expected. Medication management is an important part of providers helping residents with HIV/AIDS adhere to their treatment regimens and manage their overall health. Long-term care pharmacies can be invaluable partners who have a wealth of solutions and knowledge to support care of this population.

    Unique needs and solutions

    It’s been 32 years since the Food and Drug Administration approved the first HIV/AIDS drug. AZT, also called Zidovudine and Retrovir, stops the reproduction of DNA and reduces the amount of HIV in the body, which allows the immune system to function better. This drug helps people with HIV/AIDS live longer and healthier lives. Since 1987, about 40 more drugs have joined AZT as treatment options. These medications help suppress the virus and reduce the risk of transmitting it to others. However, age-related issues can complicate ART in older adults. For example, liver and kidney functions decline with age and this can make it more difficult for a person to process HIV drugs and lead to increased risk of side effects. Guidance on use of antiretrovirals in older people from the U.S. Department of Health and Human Services advises that “special attention should be paid to the greater potential for adverse effects of ART on renal, liver, cardiovascular, metabolic, and bone health.” Older adults with HIV are also more likely to be on medication to manage other chronic diseases and this may be problematic.  

    “Many antiretrovirals have numerous drug interactions. Generally, older people are on more medications so the potential for drug interactions is higher,” said John Dombach, general manager at Turenne PharMedCo Pharmacy Services in Tennessee. “Turenne monitors for drug interactions on initiation of a medication and with any medication change.”

    There are no specific HIV medication recommendations for older adults. The choice of HIV treatment is largely dependent on individual needs, but a pharmacy services provider can help tailor solutions for treatment challenges.

    “For example, if a resident has had a stroke or has a disability, they may have difficulty swallowing the complex regimens. The pharmacist can help recommend alternative dosage formulations or regimens,” said Sarah Barker, general manager at Turenne PharMedCo Pharmacy Services in Montgomery, Alabama.

    Pharmacists were on frontlines

    Treating HIV/AIDS is a delicate balancing act that requires a knowledgeable healthcare team. Pharmacists have been on the frontlines of supporting care for HIV-positive people since the epidemic’s early days in America. Before the advent of ART, they managed the difficulties of addressing opportunistic infections. The available medications were limited and sometimes toxic. Pharmacists and physicians had to work together to prevent complications and drug interactions. There are dozens of antiretroviral medications available now, but a team approach is still needed to care for HIV-positive people, especially as they age. Partnering with a pharmacy provider that understands this population’s challenges is important for long-term care facilities. Together, they can support HIV-positive residents in maintaining their highest level of function and quality of life.

    Turenne PharMedCo Pharmacy Services employs a highly-experienced clinical staff who specialize in geriatric pharmacy. We offer custom dispensing, enhanced labeling and packaging, pharmacy operations tools, expanded hours, personal delivery and emergency service.
    To learn more about how our agility and customizable services and solutions can help you, call 1-866-710-7626.


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