Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, New York, USA.
Gerontology. 2023;69(8):946-952. doi: 10.1159/000530723. Epub 2023 Apr 18.
Due to effective anti-retroviral therapy (ART), the people with HIV are aging, and this is observed globally wherever ART is readily available. While this represents the success of HIV treatment, those aging with HIV face several health challenges that emphasize the importance of access to health care and health equity. These challenges include changes to the immune system, chronic inflammation, and higher rates of multimorbidity at younger ages compared to people without HIV. Intersectional identities impact health care access and health equity and include age, sexual orientation, gender identity, race/ethnicity, socioeconomic position, and HIV serostatus. Intersectional identities are also associated with psychosocial burdens among older adults with HIV such as depression, social isolation, and HIV stigma. Social integration of older people with HIV can mitigate some of these burdens and is associated with better psychological well-being, better physical functioning, and greater sufficiency of informal social supports. There are several grassroots and advocacy initiatives to improve health equity and social integration which bring greater visibility to HIV and aging. These efforts should be coupled with a systematic and sustained policy response to the aging of this population that prioritizes human needs and is grounded in principles of social justice. Action must be taken, and this responsibility falls on policymakers, health care professionals, researchers, and community advocates alike.
由于有效的抗逆转录病毒疗法（ART），HIV 感染者正在老龄化，这在全球范围内都有观察到，只要 ART 易于获得。虽然这代表了 HIV 治疗的成功，但随着 HIV 一起衰老的人面临着许多健康挑战，这强调了获得医疗保健和医疗保健公平的重要性。这些挑战包括免疫系统的变化、慢性炎症，以及与没有 HIV 的人相比，在更年轻的年龄就出现更高的多种合并症发生率。交叉身份会影响医疗保健的可及性和医疗保健公平，包括年龄、性取向、性别认同、种族/民族、社会经济地位和 HIV 血清状态。交叉身份也与 HIV 老年患者的心理社会负担有关，如抑郁、社会孤立和 HIV 耻辱感。HIV 感染者老年人的社会融合可以减轻其中一些负担，并与更好的心理健康、更好的身体功能和更充足的非正式社会支持相关。有一些基层和宣传倡议旨在改善健康公平和社会融合，这些倡议使 HIV 和老龄化问题更加引人关注。这些努力应该与针对这一人群老龄化的系统和持续的政策应对措施相结合，该措施优先考虑人类需求，并基于社会正义原则。必须采取行动，而这一责任落在政策制定者、医疗保健专业人员、研究人员和社区倡导者身上。
