Health Library Home>Wellness Centers>Sexuality & Health>Article

HIV Treatment: The Challenges for Older Adults

Improved medications have helped many people with HIV live longer, but treating older adults with HIV presents some unique challenges.

The challenges related to diagnosing HIV in older adults have been well documented. Both doctors and their patients can sometimes feel uncomfortable discussing risk factors, such as unprotected sex and injection drug use. Also, symptoms of HIV can mimic symptoms of other conditions that are common in older adults.

After a diagnosis is made, however, there are additional challenges for older adults with HIV and the doctors who treat them. The most effective combination of drugs can interact with medications these adults frequently take for a host of other conditions, such as high blood pressure.

Drug Interactions

The protease inhibitors that are a critical part of treating HIV inhibit an enzyme in the liver that metabolizes other medications, raising the risk of drug interactions.

Generally, your doctor will try to avoid prescribing drugs that interact. In some cases, that may not be possible since the drugs are necessary.

HIV drugs increase the risk of certain conditions, such as high cholesterol andtriglycerides, kidney stones, pancreatitis, and liver disease. Plus, the volume and range of medications that older people take also increases the risk of drug interaction.

Remembering to Take Medications

Another issue is getting people to remember to take all of their medications. Regimens involve multiple drugs and can be complicated and time-consuming.

One of the most common reasons people with HIV do not take their medications is because they forget. Forgetting to take medications can be serious for someone with HIV. Taking medications on a regular basis helps maintain or decrease the amount of the virus in the body, called viral load.

The decrease in viral load improves overall health and quality of life. Evidence from one study found that people who took their medications 95% or more of the time spent less time in the hospital, and had fewer infections, and deaths.

Some Good News

There is good news, however, on 2 fronts. Those who take their medication have a better chance of getting a positive response. And older adults may experience the same benefits from treatment as do younger people. Seniors also may demonstrate adherence because they may be more used to medication routines.

Also, new regimens are helping people get a better handle on their health. These include taking less pills per day, which makes it easier to adhere to treatment plans.


National Institute of Allergy and Infectious Diseases

US Department of Health and Human Services


Canadian AIDS Society

Public Health Agency of Canada


Antiretroviral therapy for HIV infection. EBSCO DynaMed website. Available at: Updated December 21, 2016. Accessed February 14, 2017.

Gebo KA, Justice A. HIV infection in the elderly. Curr Infect Dis Rep. 2009;11(3):246-254.

Gebo KA, Moore RD. Treatment of HIV infection in the older patient. Expert Rev Anti Infect Ther. 2004;2(5):733-743.

Mills EJ, Nachega JB, et al. Adherence to HAART: A systematic review of developed and developing nation patient-reported barriers and facilitators. PLoS Med. 2006;3(11):e438.

Paterson DL, Swindells S, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133(1):21-30.

Ship JA, Wolff A, et al. Epidemiology of acquired immune deficiency syndrome in persons aged 50 years or older. Journal of Acquired Immune Deficiency Syndromes. 1991;4;84-88.

Silverberg MJ, Leyden W, et al. Older age and the response to and tolerability of antiretroviral therapy. Arch Intern Med. 2007;167:684-691.

Walker AS, Doerholt K, et al. Collaborative HIV Paediatric Study (CHIPS) Steering Committee. Response to highly active antiretroviral therapy varies with age: The UK and Ireland Collaborative HIV Paediatric Study. AIDS. 2004;18:1915-1924.

Workowski KA, Berman S, et al. Sexually transmitted diseases treatment guidelines, 2010. MMWR. 2010;59(No. RR-12):1-110.

Last reviewed February 2017 by Michael Woods, MD, FAAP  Last Updated: 3/6/2015