Issues of Ageing With HIV | Document

Running head: ISSUES OF AGEING WITH HIV
ISSUES OF AGEING WITH HIV
Name of the Student
Name of the University
Author Note

1ISSUES OF AGEING WITH HIV
INTRODUCTION
Human Immunodeficiency Virus (HIV) belongs to the Retrovirus group of viruses. It
causes numerous problems when an individual gets infected with this virus. It has a very long
incubation period (World Health Organization, 2020). It finally manifested into what is
known as Acquired Immunodeficiency Syndrome (AIDS) (Centers For Disease Control And
Prevention, 2020). Without any treatment, the average time of survival is 11 years (World
Health Organization, 2020). While this severe condition affects anyone of any age, it has
been seen that majority of the patients are ageing adults over the age of fifty. The struggles
faced by this demographic are much different from those faced by their younger counterparts
and this includes social, economic and personal reasons.
The first instance of HIV/AIDS in Canada came under notice in 1982. Study shows
by the end of 2016, about 63,100 individuals were contracted with this disease and 9090
individuals have already contracted this disease but yet not diagnosed (Catie.ca, 2020).
However, because of the gradual improvement in the treatment procedure of AIDS in the
form of highly active antiretroviral therapy mortality has decreased. This report aims to focus
on the several issues faced by the ageing population suffering from HIV, their living and
social situations, as well as touching on to the aspects of palliative care and why it is essential
for the demographic in question.
DISCUSSION
STATISTICAL DATA
It has been observed that the prevalence or instance of HIV/AIDS is increasing among
the aboriginal Canadians resulting in about 11.3% new cases by the end of 2016. Among this
population, there is a huge subpopulation of ageing individuals who have contracted this

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disease. According to various studies it is calculated that till 2010, the percentage of senior
Canadians above the agee of 65 was about 14.1 and it is also guessed that by the end of 2036
the percentage will be almost double that is 23-25 (Canadian AIDS Society, 2020). It is also
seen that among this subpopulation approximately 15.6% of the individuals were suffering
from HIV/AIDS and it is estimated that this percentage will also be doubled within two
decades (Canada.ca, 2020). The reasons for estimating the population doubling within 2036
are Canadians already diagnosed with HIV/AIDS are living much longer than previous cases
because of the improved treatments and there are still numerous cases in which individuals
are diagnosed with this disease at a much older age. Another report estimated that by the end
of the year 2025, one out of six HIV/AIDS affected Canadians will be more than 50 years old
(Sok, 2019). Government surveillance revealed that the cases of HIV/AIDS among
individuals of the age of more than 50 are resulting from various activities and differs from
individual to individual. It showed that in the year 2016, about 88% of the cases were because
of unprotected sex among which, 49% cases were caused by homosexuality. Apart from
sexual activity, 12% of the individual contracted HIV/AIDS because of taking intravenous
drug injection (Cdc.gov, 2020). Social stigmas like homophobia, sexism, racism, stigma
against drug abuse and sex work are some of the examples that hugely affect the treatment
that results in secretive behaviour of the individuals diagnosed with HIV/AIDS (Wagner et al.
2017). This further resulted in an increase in the percentage of individuals suffering from this
disease who remain undiagnosed or untreated.
ISSUES OF AGEING WITH HIV
Though it has been observed that the life expectancy of individuals who have
HIV/AIDS has increased significantly because of the advancement in treatment in the form of
highly active antiretroviral therapy, however, there are quite a few problems that arise when
an ageing individual has AIDS. It is a well-known fact that as an individual age, his or her

3ISSUES OF AGEING WITH HIV
immune system gradually weakens. According to the theory of errors, ageing involves the
fast wear and tear of the tissues as the muscles lose their flexibility and the bones become
fragile. The pathogens attack easily already and the quality of life deteriorates. On addition
to that, when an individual develops AIDS because of HIV infection, his or her immune
system becomes hugely affected, and as a result, the individual becomes entirely immune-
compromised (AIDSinfo, 2020).
It has also been observed that individuals with AIDS start developing various ageing-
related disorders sooner than others. They suffer from an increased threat of internal or
external chronic inflammation which includes diseases like lymphoma, diabetes and
cardiovascular diseases. HIV infection and treatment after diagnosis also affects the brain.
Disease like dementia is very much prevalent in the ageing population having AIDS (Furlotte
& Schwartz, 2017). Further studies on the effect of the brain in ageing individuals having
AIDS reveal that 50% of the subpopulation develop HIV-Associated Neurocognitive
Disorders (HAND) that includes various cognitive disorders like issues regarding motor
skills, lack of attention, language problems, poor memory which affects the day to day life
significantly (Daniel et al., 2015). The undiagnosed individuals are at higher risk of various
other diseases like cardiovascular diseases, renal issues including hepatitis and cirrhosis, lung
disease and even lead to cancer in some cases (HIV.gov, 2020). Surveillance data from CDC
also revealed that 35% of the population above the age of 50 when diagnosed with HIV
infection were in the late phase of the disease and were already suffering from quite a few
illnesses mentioned above.
The reasons behind this immunocompromised state and other diseases lie in the fact
that in older age the reservoir of various immune cells starts decreasing because of the level
of Thymosin, a hormone secreted from Thymus gland gradually decreases with age
(Medicineplus, 2020). Thymosin hormone is responsible for producing T cells, one of the

4ISSUES OF AGEING WITH HIV
immune cells responsible for the building of immunity. Apart from this, immunity of the
individuals having HIV infection also decreases compared to the average rate as HIV inhibits
the production of the T cells. There are two types of T cells which are CD4+ cells and CD8+
T cells. HIV infection entirely inhibits the production of these two cells. The effect of this
inhibition also falls on B cells, another type of immune cell and its production rate depletes as
well (Doitsh et al., 2014). Though the functionalities of macrophage remain existent, but to a
small extent because of the absence or a limited number of CD4+ T cells that regulated its
proper functioning. The combined effect of these two points affects the HIV infected
individuals’ immunity significantly and results in an immunocompromised state.
HOUSING RELATED ISSUES
Housing is a significant issue among the elderly population suffering from
HIV/AIDS, mostly because of the social stigmas that are quite prevalent to date (Slater et al.
2015). The life expectancy of the individuals having AIDS has increased since the invention
of highly active antiretroviral therapy significantly. As a result, the population containing
HIV infected older adults have grown. Now the problem lies in the residential
accommodation of these people. Most of the people are not very vocal of the condition they
are suffering from as they are ashamed of the disease and quite afraid of the related stigmas
and their societal positions. This fright has even caused them to keep their problems withheld
and undiagnosed which lead to further health complications and thus, they are diagnosed with
HIV infection at an older age and the late stage of the disease. It has also been observed that
people lose friends, more than often, their families throw them out of their residence, and
they are even abandoned from society (Guirguis-Younger, Hwang & McNeil, 2014).
This situation has also lead to an increased risk of the elderly population to be
homeless. They are also not allowed to stay in many apartments, and they can not even go for

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expensive residential areas as the treatment of AIDS is quite costly, and not many individuals
can bear both the expenses. The healthcare facilities and hoes for older adults that already
exist are also not a very good option for HIV patients to stay as they lack many facilities.
Individuals who have HIV/AIDS have quite a few unique needs as they also have various
HIV related diseases and needs to consume many medicines, and during emergency
situations, they also need high-end treatments which might not be available in those places
(Chamber et al., 2014). These problems lead to an increased homelessness status to
numerous Canadians suffering from HIV infection. The homeless individuals with this
condition live in a deplorable state with almost no money and no treatment. Though there
have been quite a few campaigns to raise awareness among people and make them
understand the facts, to grow sensitivity and discard all the social stigmas regarding
HIV/AIDS that are increasingly exerting a negative effect on these individuals and making
their condition more miserable but there are not many positive outcomes which have been
observed (Logie et al., 2018). A surveillance report from the CDC shows that about 35% of
the homeless individuals are having HIV/AIDS and thus abandoned from their residence or
are left with no penny. So, it is crucial for the government to build healthcare facilities and
proper housing for HIV infected individuals. Newer health policies are also required to
facilitate their proper treatment.
ROLE OF NURSES
Ageing individuals who have HIV/AIDS require specialised care because of the
increasing complications that arise each passing day. The older individuals need much more
intensive care than the younger individual requires because of the fragility. It has been
observed in and around Canada that there are not many healthcare facilities designed
according to the various needs of HIV affected older people (Mill et al., 2014). It was also
noted that most of the nurses are also not properly trained to handle older individuals having

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AIDS and their mindsets are also filled with the social stigmas which are prevalent around
(Solomon et al., 2014). The nurses have a crucial role to play in treating or taking care of
HIV infected older individuals. The health of the patients undergoes a drastic change at this
phase both physically and mentally.
Gerontological nursing is a stream of nursing where the nurses specialise in nursing
older patients along with their families so that support is provided to facilitate healthy ageing
and maximum functioning. It is a crucial field as the older adults’ requirements vary quite a
bit with the care provided to younger adults (Clory & Hood 2015). They are much required to
support older patients having HIV/AIDS.
Physically, the patients suffer from various diseases which are brought into the scene
because of AIDS. Owing to their different ailments, they need to consume quite a few
medicines which are a duty of the nurses treating these patients to provide the patients and
making sure that they consume that medicine. Apart from this, the nurses need to take care of
the minute changes and problems the patients are undergoing. Nurses should also report the
complications and newer problems they are noticing to the doctor so that early detection of
various other complications take place and thus they can be addressed (Lewis et al., 2016).
Apart from the comorbidities that are prevalent in HIV infected older people, another
problem is the psychological or mental condition of the patients. Most of the patients mainly
the older individuals suffer from clinical depression and anxiety issues at this phase which
further leads to the degradation of their health. Initially, the patients take up a sufficient
amount of time to get adjusted to the idea that they are having an HIV infection. Gradually,
they register the fact and get depressed thinking of this. A nurse has quite a few
responsibilities to address during their phase of depression. They need to comfort them and
make them understand the treatments available that can give them a longer life expectancy.

7ISSUES OF AGEING WITH HIV
Motivating them and supporting them emotionally can improve their mental condition. The
nurses should also take the responsibility of helping them to be physically fit by eating
healthy and nutritious food and daily exercises (Morrison-Valfre, 2016).
In case of more serious mental condition, the nurses should report to the psychiatrist
and follow his or instructions. Loneliness is an issue that also harms these people, and it can
be overcome by speaking with these individuals and positive behaviour (Price, 2015).
LARGER SYSTEM IMPLICATION
Housing accommodation and proper care is always a problem for patients having
HIV/AIDS. The reasons for both these issues are discussed in the previous sections. The
abandoned individuals mostly spend the rest of their lives on the road in a miserable
condition. The possible options to change this condition is either building housings for the
affected individuals with all the requirements or palliative care centres. The former option
requires more time in planning and carrying the process out; however, the latter option is
much suitable for HIV infected patients.
Palliative care is a service that is provided to the people who are suffering from
terminal illnesses to decrease their and their family’s pain. It is also aimed to provide them
with the best quality treatment and make them live their life in the best way possible (Kelley
& Morrison, 2015). However, there is a taboo regarding palliative care services that it is for
dying people which is not entirely accurate. There are numerous instances where people have
been cured or lived for a long time, even after suffering from a terminal illness. For these
rumors, many individuals avoid getting palliative care as they think palliative care is a service
for dying people. So, awareness needs to be spread to break these false notions (McIlfatrick
et al., 2014). Palliative care is one of the best places where older adults having HIV/AIDS
can get admitted to ease their pain and for living their lives to the fullest. It is crucial for the

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palliative care facilities to have nurses and experts in taking care of ageing people having
HIV/AIDS. The ageing people with HIV infections happen to be extremely frail as they are
entirely immunocompromised and suffer from different comorbidities altogether. Study
shows that older adults having HIV/AIDS, when took help from palliative care, their life
expectancy increased, and their conditions improved to some extent as well. So, in the
coming years, it is essential to conduct more researches on palliative care. Everyone should
have proper knowledge of this facility so that appropriate implementation takes place (World
Health Organization, 2016).
CONCLUSION
Thus, from this study, we can conclude that the number of individuals who have
HIV/AIDS is ever increasing in Canda and it is essential to provide them with proper
facilities to live properly. The social stigmas are also playing the villain and affected
individuals are getting abandoned and end up being on the road and stay without any
treatment or shelter. So, proper awareness should be spread across everyone to be more open-
minded and take care of the people with this disease. It is essential for the nurses in medical
facilities to provide the required treatment and make the patients’ lives a bit more liveable by
counselling them and talking to them. It is also essential to develop more palliative care
facilities and spread information about them so that ageing people having HIV/AIDS can take
their help and live in an appropriate shelter with required medication and other facilities.

9ISSUES OF AGEING WITH HIV
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