By: Marcus J. Hopkins, Health Policy Lead Consultant, ADAP Advocacy
HealthHIV has released its fifth annual survey on the State of Aging with HIV™, finding both positive and negative results from patients and providers alike. This report details survey findings and implications across five areas: HIV and Geriatric Care, Comorbidities, Behavioral Health, Access and Payment, and Workforce.
HealthHIV summarized the survey as follows:
"The survey revealed an HIV care system that delivers clinical wins. Over 98% of consumers reported being virally suppressed, and nearly 100% are taking antiretrovirals, the highest rates across five waves of the survey. The same data, however, show that the broader clinical reality of aging with HIV, multimorbidity, frailty risk, mental health burden, and the structural conditions of daily life, is not being managed with the same consistency."
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| Photo Source: HealthHIV |
Key findings include:
Viral Suppression is High Among Older People Living with HIV/AIDS
Among People Living with HIV/AIDs (PLWHA) surveyed, 98% reported that their HIV was virally suppressed. This is significantly better than the national average of 62% (CDC, 2026).
While viral suppression was reported to be high, respondents indicated that age-related testing, screening, and other geriatric care were significantly lacking. Just 17% of respondents reported being screened for HIV-related medical frailty, with screenings for frailty declining from 25% of patients under the age of 65 being screened in 2022 to just 11% in 2026. HealthHIV found that patients with lower incomes were significantly less likely to be screened at all.
PLWHA Are Heavily Burdened by Comorbid Non-HIV Chronic Conditions
More than 80% of respondents indicated that they have at least one non-HIV-related chronic condition for which they are currently taking prescription medications, of whom 22% reported having to change their antiretroviral (ARV) medication due to a contraindication with another drug.
HealthHIV’s analysis of responses found that more than 25% of respondents have very high medical needs, but are underserved.
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| Photo Source: HealthHIV |
Behavioral and Mental Health Issues Are Prevalent Among Older PLWHA
More than 75% of respondents indicated having moderate or high levels of stress, but fewer than 2% of respondents identified mental health as being an immediate need. Many respondents indicated that they had a “good” quality of life, but also carried high levels of stress. HealthHIV suggests that this finding indicates that respondents place more importance on the outward appearance of wellness while simultaneously ignoring or disregarding mental health as a part of a “good” quality of life.
Research has found that high levels of psychological stress can have negative impacts on PLWHA and their physical health and health outcomes. For example, traumatic and stressful life experiences have been associated with reduced adherence to treatment regimens, virologic failure, higher rates of mortality and opportunistic infections, increases in the use of recreational drugs in such ways that may result in behaviors detrimental to the health of both the patient and others, and arterial inflammation (Reif et al., 2013; Chow et al., 2023).
Access to and Paying for Medications and Treatment is Likely to Get Tougher for PLWHA in the Future
While existing programs and insurance coverage of ARV treatments are currently working, HealthHIV reports that those systems, like PLWHA who are aging, are becoming increasingly frail.
HealthHIV highlights reports that state AIDS Drug Assistance Program (ADAP) budgets are becoming increasingly strained, and that the reintroduction of waiting lists (Hopkins, 2026) in Iowa and Utah presages tough times ahead for PLWHA who are aging.
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| Photo Source: HealthHIV |
According to the survey, fewer than half of respondents had retirement plans (largely because many didn't expect to live into their 50s), almost one-third reported food insecurity, and one in five avoided care due to cost.
Respondents to HealthHIV’s survey reported that transportation remains the strongest single barrier to accessing care and treatment, with lower-income patients being six times more likely to miss an HIV appointment because they cannot get to the appointment. Additionally, HealthHIV reports that more than half of Medicare enrollees still rely on the Ryan White HIV/AIDS Program (RWHAP) and ADAP to access HIV medications.
Providers Are Largely Unequipped to Effectively Treat Aging PLWHA
Providers who responded to HealthHIV’s survey reported that, while they understand that aging PLWHA face unique needs that require specialized care, they currently lack the staff, funding, or expertise to provide these services.
HealthHIV found that just 1.2% of provider respondents specialized in gerontology, compared with 21% with specializations in HIV medicine. Moreover, they found that workforce turnover is eroding the institutional knowledge and awareness of both the history of the HIV epidemic and the cultural and lived experiences of aging PLWHA.
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| Photo Source: HealthHIV |
Regarding aging-care readiness among patients, providers reported troubling trends. Among them, only half were aware of the protections afforded to them under the Americans with Disabilities Act (ADA), a fact that is particularly important for end-of-life planning. Fewer than one-fourth of providers offer advance care planning, which is compounded by the fact that only 16% of caregivers report having adequate support.
In Closing
HealthHIV has made available the final report for its fifth State of Aging with HIV™ survey on its website at healthhiv.org/stateof/agingwithhiv/. On May 6th, HealthHIV hosted an educational webinar, and free access to this on-demand webinar is available online, along with the presentation slides.
At this point in history, more than half of PLWHA are over the age of 50, making this research essential to maintaining a robust and effective HIV care continuum.
Disclaimer: All funders of the ADAP Advocacy Association are publicly listed on our website.
Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association; rather, they provide a neutral platform for the author to promote open, honest discussion of public health-related issues and updates.
References:
[1] Centers for Disease Control & Prevention. (2026, March 16). Behavioral and Clinical Characteristics of Persons with Diagnosed HIV Infection—Medical Monitoring Project, United States, 2023 Cycle (June 2023—May 2024). Atlanta, GA: United States Department of Health and Human Services: Centers for Disease Control and Prevention: HIV Data: Medical Monitoring Project. https://www.cdc.gov/hiv-data/mmp/behavioral-clinical-characteristics-pwh-2023.html
[2] Chow, F. C., Mundada, N. S., Abohashem, S., La Joie, R., Iaccarino, L., Arechiga, V. M., Swaminathan, S., Rabinovici, G. D., Epel, E. S., Tawakol, A., & Hsue, P. Y. (2023, October). Psychological stress is associated with arterial inflammation in people living with treated HIV infection. Brain, Behavior, and Immunity, 113, 21-28. https://doi.org/10.1016/j.bbi.2023.06.019
[3] HealthHIV. (2026). Findings and implications from HealthHIV State of Aging with HIV Fifth Annual Survey. Washington, DC: HealthHIV: State of. https://healthhiv.org/stateof/agingwithhiv/
[4] Hopkins, M. J. (2026, May 14). The ADAP “Perfect Storm” Returns; Over 1,000 Patients Being Denied Care. Nags Head, NC: ADAP Advocacy: Blog. https://adapadvocacyassociation.blogspot.com/2026/05/the-adap-perfect-storm-returns-over.html
[5] Reif, S., Mugavero, M., Raper, J., Theilman, N., Leserman, J., Whetten, K., & Pence, B. W. (2011, February). Highly Stressed: Stressful and Traumatic Experiences among individuals with HIV/AIDS in the Deep South. AIDS Care, 23(2), 152-162. https://doi.org/10.1080/09540121.2010.498872
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