So you’re poz
You are not the only one. Over 1 million Americans are poz and estimates are that, within the next few years, over 50 percent of those people will be over 50 years of age.
When to start treatment?
You, along with your doctor, have to decide when to start treatment. However, the Centers for Disease Control issued new guidelines last March for poz people over 50. The new guidelines say that everyone over 50 who is infected with HIV, no matter what his or her t-cell count, should be on anti-retroviral therapy. The CDC says that the risks of treatment are less than the risks associated with the natural process of aging combined with the potential damage from the HIV virus or other health issues.
What to take?
There are now 30 different FDA-approved medications to treat HIV infection. From the glass-half-full perspective, you have many options to choose from in case you react poorly or become resistant to one or more treatments. The half-empty-glass perspective is the side effects — each drug has its own. Another conversation with your doc is required.
What are the side effects?
You’ve heard about most of them or have had them: facial wasting, lipodystrophy, diarrhea, kidney stones, high cholesterol, triglycerides and creatinine, and the list goes on ... diabetes, anemia, liver disease, coronary disease, cancer, depression ... fun, fun, fun. Not to mention the long-term effects of the HIV infection itself: dementia, enlarged organs, osteoporosis, cataracts, etc. And for those who have had opportunistic infections, don’t forget the damage that was done to your body by those episodes. Whatever the side effect, you guessed it, have a conversation with your doctor.
How long to stay on treatment?
As it stands now, forever. Some say that drug holidays are OK, but there is still debate on this issue. Another one of those “talk to your doc and then you decide what is best for you” issues.
What about aging?
There is research that indicates that, in some way, HIV infection speeds up, or appears to speed up, the aging process. That process, combined with the side effects of medication and HIV, is probably not great news for your body. Some suggest that you are at higher risk, at an earlier age, for the typical diseases of aging: coronary, liver and kidney disease and all of the other standards. Along with all of those typically age-related diseases and conditions come more drugs. Their interaction with the HIV medication has to be carefully monitored by you, your docs and your pharmacist.
Is there any good news?
The best news is that you are still here to read this. The second-best news is that we know much more about the virus, the drugs, the side effects and how to manage all of that. We know that paying attention to your physical and emotional health plays a large role in your ability to manage the infection. Exercise, nutrition and emotional outlook all contribute to survival and your quality of life.
Even more good news is that cosmetic treatments are available to help manage both the physical manifestations of HIV and the emotional toll they take. Sculptra, Egrifta, Botox and others, although expensive, can help you cope with the effects of the trifecta of HIV, medications and aging.
Want more information?
More information is available and will be presented at an LGBTEI Community Forum, “HIV & Aging: What’s New,” Sept. 18 at the William Way LGBT Community Center. Presented by the LGBT Elder Initiative in collaboration with Philadelphia’s AIDS Activities Coordinating Office and William Way, the workshop will address many of these and other issues facing people living with HIV/AIDS as they age.
To register or receive more information about the workshop, email your name and telephone number to email@example.com or call 267-546-3448.
Ed Bomba is communications chair of the LGBT Elder Initiative. The LGBTEI fosters and advocates for services and resources that are competent, culturally sensitive, inclusive and responsive to the needs of LGBT older adults. To comment on this column, suggest future topics or for more information, visit www.lgbtei.org
or call 267-546-3448 and watch for “Gettin’ On” each month in PGN.