Prevalence of HIV and chronic comorbidities among older adults

Abstract

Objectives Limited evidence is available on HIV, aging and comorbidities in sub-Saharan Africa. This article describes the prevalence of HIV and chronic comorbidities among those aged 50 years and older in South Africa using nationally representative data. Design The WHO’s Study of global AGEing and adult health (SAGE) was conducted in South Africa in 2007–2008. SAGE includes nationally representative cohorts of persons aged 50 years and older, with comparison samples of those aged 18–49 years, which aims to study health and its determinants. Methods Logistic and linear regression models were applied to data from respondents aged 50 years and older to determine associations between age, sex and HIV status and various outcome variables including prevalence of seven chronic conditions. Results HIV prevalence among adults aged 50 and older in South Africa was 6.4% and was particularly elevated among Africans, women aged 50–59 and those living in rural areas. Rates of chronic disease were higher among all older adults compared with those aged 18–49. Of those aged 50 years and older, 29.6% had two or more of the seven chronic conditions compared with 8.8% of those aged 18–49 years (P < 0.0001). When controlling for age and sex among those aged 50 and older, BMI was lower among HIV-infected older adults aged 50 and older (27.5 kg/m2) than in HIV-uninfected individuals of the same age (30.6) (P < 0.0001). Grip strength among HIV-infected older adults was significantly (P=0.004) weaker than among similarly-aged HIV-uninfected individuals. Conclusion HIV-infected older adults in South Africa have high rates of chronic disease and weakness. Studies are required to examine HIV diagnostics and treatment instigation rates among older adults to ensure equity of access to quality care, as the number and percentage of older adults living with HIV is likely to increase.

Multimorbidity in non-communicable diseases in South African primary healthcare

“…[7] Notably, there is work that suggests that 30% of older patients with HIV may have comorbidity with other chronic diseases. [16] It is also possible that treatment for NCDs is being given to HIV-positive patients in HIV clinics. Future research is required to investigate these comorbid conditions within the HIV context, especially as HIV-positive patients who were diagnosed in young adulthood mature.…”

Health expenditure and catastrophic spending among older adults living with HIV

“…Findings on health expenditure and catastrophic spending conducted on adult populations cannot necessarily be extrapolated to older people who differ in terms of poverty rates (Ramashala, 2001), health access, and disease burden (Albanese et al, 2011;Negin, Martiniuk, et al, 2012).…”

“…An estimated 4.2 million people worldwide aged 50 and older are living with HIV (Mahy, Autenrieth, Stanecki, & Wynd, 2014), with recent estimates from South Africa predicting HIV prevalence in adults aged 50 and older will nearly double from 9% in 2010 to 17% in 2040. Older adults with HIV face a greater health and financial burden, with greater risk of non-communicable diseases (Negin, Barnighausen, Lundgren, & Mills, 2012;Negin, Martiniuk, et al, 2012).…”

Demographic and epidemiological characteristics of HIV opportunistic infections among older adults in Nigeria

“…Sub-Saharan Africa is lagging behind in terms of literature on the characteristics of HIV infection in older adults. Negin et al found that 29.6% of persons aged 50 years and above in South Africa had two or more chronic diseases compared to 8.8% in age group 18-49 years 15 . Meanwhile, Nyirenda et al showed that older adults in Uganda and South Africa had poorer emotional and functional wellbeing 16 .…”