Medicare Study Finds High Rates of Chronic Health Conditions in HIV-Positive Elders

The availability of effective antiretroviral treatment has dramatically increased in the life expectancies of persons living with HIV. In the U.S., the proportion of HIV-positive persons over age 50 continues to rise and is projected to reach 50 percent by 2020. This "graying" of the HIV epidemic in the U.S. and globally has led to increased research on health threats to older HIV-positive persons -- both those due to chronic HIV infection and those related to the normal aging process.

To gain insight into the health status of HIV-positive persons 65 years of age or older, researchers from CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention analyzed fee-for-service Medicare claims data for the years 2006 through 2009. They calculated the prevalence of chronic health conditions among these HIV-positive Medicare beneficiaries HIV and compared the prevalence rates to Medicare beneficiaries without HIV.

The CDC researchers found that, of the 29.1 million Medicare beneficiaries studied, 24,735 (0.09 percent) were HIV-positive. The proportion of HIV-positive beneficiaries who were Hispanic or African American was about five times higher, compared to beneficiaries without HIV. The HIV+ beneficiaries were about twice as likely as those without HIV infection to have chronic health conditions such as high blood pressure, ischemic heart disease, rheumatoid arthritis/osteoarthritis, or diabetes. They were also much more likely to have one to five comorbid health conditions than the uninfected beneficiaries.

The researchers conclude that, "with the aging HIV-positive patient population, HIV providers in the Medicare network will have to prepare for patients with different medical needs, including a higher likelihood of chronic co-morbid health conditions. Similarly, chronic disease practitioners who serve in the Medicare network, such as cardiologists and endocrinologists, should be aware that their Medicare patients may be receiving treatment for HIV infection. Greater collaboration between infectious disease and chronic disease practitioners will be needed to ensure the appropriate medical management of these patients including complex medication regimes."

Eric Brus is the Director of Health Information at AIDS Action Committee. This report is produced by the Health Library of the AIDS Action Committee in collaboration with the New England AIDS Education and Training Center Minority AIDS Initiative Project. The full version is available online.