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AGING WITH HIV: Bringing the latest research to bear in providing care By David E.

Vance, PhD, MGS

There were only few research regarding the relationship between HIV infection and the aging process. In one study, research was made comparing the survival rates and clinical manifestations of HIV positive people who are 45 years of age or younger to those who are 46 years old and above. It was found out that there was a big difference of the result. The older group manifested a more drastic weight loss compared to those who are younger. There were also congestive heart failure, stroke, hypertension, diabetes and cancer. This is may be due to the effect of age in metabolizing and using the drug. The HIV drug can be highly toxic which may be the reason for the development or exacerbation of heart disease etc. Some evidence shows that interactions among HIV infection, HIV pharmacotherapy and the aging process can result in an increase risk of comorbidities. In adults with HIV, cognitive declines are present. A lot of cognitive domains can be affected. This includes the speed of processing information, executive functioning and reasoning and psychomotor functioning which has a big impact on their daily routine and this can also reduce the quality of life. This journal stated some information based on some studies. It was found out that those with neuropsychological impairment performed poorly when it comes to computer related driving test compared to those who are not. It was also found out that aging and substance abuse have a significant relationship to each other as this can increase the risk of cognitive impairment but their exact relationship or interaction with each other still remains unclear. Although older adults tend to be more adherent to their drug regimens, it was the opposite for older adults diagnosed with HIV. Those adult who also have cognitive impairment tends to comply less to their medications compared to those who are not impaired. This poor adherence can also lead to unwanted results. In terms of social and emotional problems, the elderly with HIV have fragile social networks which aids to a lower chance of having a support group. This has a big impact on their lives which can actually result to depression and suicidal ideation. According to Shippy and Karpiak, they found out that 58% of participants reported being depressed. On the other hand, In a study of 113 adults ages 45 years or older (mean age, 53 years) with HIV or AIDS, Kalichman and colleagues found out that 27% had had thoughts of suicide within the past week. The said level of suicidal ideation was actually 8% higher than that found in a study of 2,909 HIV-positive adults (mean age, 42 years). In this case, depression and suicidal ideation might also be factors in substance abuse, poor adherence to treatment regimens, or further social withdrawal.

Reaction: The nursing implication plays a vital role in older patients with HIV. Based on this article, when a person is diagnosed with HIV it is important to adhere to their drug regimens, keep health care appointments, exercise regularly, and eat healthfully. It is also equally significant to keep 3 things in mind: dutifulness, striving to achieve, and self-discipline. These are very important in caring for ones self or others. A lot of people find caring for older people with HIV more difficult or challenging than to others. This is because they need additional or extra care for comorbidities such as heart disease or depression or for problems such as social isolation. This article also stated that aging with HIV is possible especially to those newly diagnosed. A patient who believes that it is possible will probably take care of himself well or better. It is also significant for nurses to explain properly the importance of complying to their medications. Noncompliance can increase the likelihood of viral resistance to the drugs. Nurses should also ensure that their patients understood how to care for their bodies and overall health. This can actually be done through eating a healthy diet, having adequate sleep and regular exercise and managing stress.