Geriatrics and HIV care: The need is now

Trillium Health has a five-year grant from the state health department for a program for people 50-and-older who have HIV. Credit: trilliumhealth.org

Diversity has many different flavors, and part of our understanding of inclusion and diversity includes aging.

We at Trillium have a five-year grant from the state health department to develop a program for people living with HIV who are age 50 and older.

We have 850 patients with HIV, and 55% of them are age 50 and older.

HIV can be managed well if people take their medicine. But issues around aging --

heart disease, diabetes, blood pressure housing, insurance, employment, long term care, death of partners, marginalization, stigma, -- we are going to address those in an organized way because there's a huge need out there.

We're putting a group of people together that includes a nurse who oversees the program and two social workers, and what we call peer counselors, who can help patients navigate the system trying to put things together and keep people in care and in an organized way address the health needs associated with aging.

Eventually we should have all 400 and something of our 850 patients in this program. Right now we're starting with my patients because most of the patients that I follow are age 50 and older and qualify.

The health system is complicated and we're going to try and unravel some of the complications and navigate people through the system and address those problems as early as possible rather than letting them overwhelm the patient and and then impact their HIV care.

I didn’t think in 1989 or 1991 that we’d be talking about an 85-year-old with HIV. The way we put it was we could do better in those early days that we really need to do better and be better, but never really put it together quite like this. I think one of the reasons in the early days is that it was so much of a struggle with what we were dealing with currently that it was really hard to project 35 years later. It's just been in the past year that I've really noticed it in my older patients that this is way outside of what we normally consider for HIV.

It's a whole new awakening for HIV patients and providers. This is big time primary care and because there are so many people with those diverse needs, it really makes us make sense to have a program built around all of that.

We think the subspecialty of HIV geriatrics will emerge out of this. One of our partners is the Finger Lakes Geriatrics Education Center, which is a very large program of resources for those of us who are taking care of older patients. We're going to teach each other what we do.  We're going to learn geriatrics and at the Finger Lakes Geriatric Center, they're going to learn HIV.

The two have been split up to now. Geriatrics has always applied to somebody else and never applied to HIV ... and HIV people never got old. Well, not true any longer. So we're on the cusp -- yet again.