Dec 01, 2018

HIV and AIDS – A hidden story for older Australians

World AIDS Day falls on 1 December each year and is a day to show our support for people living with HIV and remember people who have been lost to the epidemic.

World AIDS Day is recognised internationally, with many countries marking the day with events to raise public awareness of HIV and AIDS care, treatment, research and prevention.

In 2017, it was estimated that there were 27,545 people with HIV in Australia. Of these, an estimated 89%, were diagnosed with the clinical syndrome AIDS by the end of 2017.

According to the latest research by Neuroscience Research Australia (NeuRA, 2018), people living with HIV are getting older faster.

Studies conclude that people in their 60s are presenting with chronic diseases more commonly seen in people 70-plus, including cognitive decline, vascular and metabolic diseases.

One factor is the use of “generation”D-drugs” – toxic drugs used before the introduction of combination anti-retrovirals – that irreparably damaged peoples’ metabolic, nervous and neurological systems.[1]

Mounting evidence also suggests that HIV frequently accelerates age-associated cognitive decline.

Up to 50 per cent of bisexual and gay men with HIV who are on treatment experience some form of mild neurocognitive dysfunction by their mid-50s. Up to 30 per cent will develop more serious neurocognitive problems and 2 to 4 per cent will develop early onset dementia[2].

One-third of people with the virus will develop a stress disorder and bisexual and gay men with HIV have 2½ times the rate of hospitalisation due to mental health and HIV-related neurological complications.

Alarmingly, more than 25 per cent have contemplated suicide and 13 per cent have attempted suicide.

It is clear from these statistics that mental health care in Australia is not geared towards those living with HIV over the age of 65[3].

old man sad

As the HIV epidemic evolves, HIV-positive individuals are ageing, utilising the resources of home-based aged care services and residential aged care facilities.

Case studies reveal that 61 per cent of people living with HIV are concerned about future placement into an aged care facility. Those who identified as gay were anxious that aged care facilities were not gay-friendly.

54 per cent were concerned about lack of HIV knowledge in aged care facilities; 42 per cent were concerned about lack of HIV experience in staff and 48 per cent were concerned about discrimination in aged care facilities due to being HIV-positive (Cummins and Trotter, 2017)[4].

In December 2017, The Australian Government released the Aged Care Diversity Framework. LASA supports this framework and its stated aim that “quality care ensures that the dignity of the human rights of each individual is embraced.

It also requires that the diverse characteristics and life experiences of the individual that may influence their care needs are met” (Department of Health, 2017)[5] The starting point for all aged care services is facilitating the process of healing the mind, body and spirit.

As providers of aged care, at times we do not know the depth and breadth of an individual’s experiences, nor do we enquire about the traumas and travails that life has dealt them.

As aged care professionals, we are called to be present where individuals find themselves; without judgement, with compassion and ever ready to assist in whatever way we can.

On this World Aids Day, let us take a moment to celebrate those in our services living with HIV-AIDS. Let us be mindful of our attitude and prejudices against those who are living with HIV-AIDS.

Let us work together to assist those who need our care. Let us do our bit in our organisations to be more inclusive, more aware, and be the “strong voice and helping hand” for those living with HIV-AIDS.

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