Abstract
Introduction
• The majority of HIV-positive Americans are over the age of 50, and older adults with HIV represent a rapidly growing segment of the global population. Life-prolonging advancements in antiretroviral therapy (ART), along with the independently growing geriatric population, contribute to this trend.
• Older adults living with HIV are at increased risk of psychiatric and neurocognitive comorbidities, in part related to the pathology of HIV and opportunistic infections, as well as stigma, chronic stress, and discrimination on the basis of HIV status, sexual orientation, gender identity, race, substance use, and/or socioeconomic status.
• This study reviews the existing literature on psychosocial factors that characterize this population, as well as psychiatric and neurocognitive manifestations of HIV in older adults, in order to better understand the epidemiology, clinical features, diagnosis, and management of these symptoms.
• A more robust understanding of these factors can lead to improvements in health maintenance, psychosocial wellness, and functioning of this population and to the development of individual and population-based treatment strategies and policies to promote health as HIV-positive individuals age.
Methods
• In this systematic review, we searched OVID Medline for articles published prior to August 9, 2021 that discussed psychiatric or neurocognitive illnesses in HIV-positive older adults.
• Search terms were: (a) HIV, AIDS, anti-retroviral, or HAART, (b) psychiatry, psychology, cognitive, neurocognitive, neurobehavioral, neurobiological, neuropsychiatric, dementia, or mental disorders, and (c) geriatric, gerontologic, aging, aged, elder, older, postmenopausal, or nursing home.
• Only English-language articles and systematic reviews were included.
• The abstracts for the articles yielded by these search criteria were then reviewed to exclude those which did not focus on HIV, older adults, and psychiatric or neurocognitive features.
Results
• See Table 1 for summary of results
Conclusions
• There is limited literature on psychiatric, psychosocial, and neurocognitive factors related to HIV in the aging population.
• The majority of articles published in this area focus on HIV-associated neurocognitive disorders (HAND), with limited discussion of other psychiatric comorbidities commonly associated with HIV.
• Further understanding of the prevalence of these symptoms and disorders in older adults with HIV, their risk factors, and evidence-based interventions are needed in order to improve timely diagnosis and treatment.
• Identifying population-based strategies for mitigating psychiatric and neurocognitive disorders, particularly in resource-limited settings, may improve adherence to ART, psychosocial well-being, and help address inequities related to the mental health of older adults with HIV.
None
Chart: https://apps.aagponline.org/abstracts/uploads/2022/9633macg2iwh9n1.pdf