ABSTRACT
Patients with HIV are living longer because of the remarkable strides that have
been made in understanding and treating both the virus and the complications
associated with it. Psychiatry has become increasingly important to HIV care
providers because of the high rates of psychiatric comorbidity found in HIV
populations. Psychiatric disorders not only play a role in the behaviors that get
people infected but also have a profound influence on heath care access and
adherence to medical recommendations. Unfortunately, not much research has
been done in the area of geriatric HIV psychiatry, but there is some useful
information from the geriatric psychiatry literature that bears directly on treating
patients with HIV, and psychiatric studies in younger patients with HIV that are
applicable to elderly HIV-infected patients. The “elderly” among the HIV
population typically refer to those living with HIV over the age of 50 years. Data
from the Centers for Disease Control and Prevention (CDC) indicate that
between the years 2001 and 2005, the estimated number of persons living with
HIV in 33 states and U.S.-dependent areas with confidential name-based HIV
reporting increased by 77% (1). At the end of 2005, 24.4% of people living with
HIV were above the age of 50 years, an increase from 16.8% in 2001 (1). The
elderly HIV patients consist of two populations, the long-term HIV survivors and
older adults who are newly infected. The time to diagnose HIV in the elderly has
been shown to be delayed (2). In the elderly, initial symptoms of fatigue, weight
loss, shortness of breath, and poor memory may be mistakenly attributed to the
aging process. Prevention efforts generally have not included the elderly in efforts to
increase safe sex practices (condom use), and there is less of an issue of pregnancy
in this population, and finally, many of these patients developed their sexual
practices in the pre-HIV era, leading to risky behavior. This coupledwith inadequate
supporting structures increases the risk of HIV acquisition in the elderly (3).
