Posted by Kimberley Meijers on June 1, 2016 at 11:31 am
If you read the previous article titled: “#AgeingHIV: Glory days, (s)he ain’t never had’ then you are aware that love and hot steaming sex has no age limit. It explained the gaps and barriers in Europe with the SRHR services. In the healthcare setting, ageism can lead to under or over prescription of medication and that can effect the quality of life of an ageing person.
This article will focus on the positive improvements that can be made so that we all can be prepared and enjoy an ageing positive (sex)life.
Do people want a future where our children, grandchildren or younger family members have to give a talk about the birds and the bees to our ageing family members? Prevention services are doing great work in providing services and safe sex messages to the general population but more attention is needed to the ageing population.
In Europe there has been no specific campaign that targets the ageing population even though this demographic is growing. A longer active sex life is being realised thanks to the availability of lubricants, pumps and pills that makes it possible for those in need of it.
Providing condoms in care homes is an easy first step that can have an impact on improving a healthy sex life. Policy maker Eleanor Briggs of the UK’s National AIDS Trust found that ageism showed its head when asking for condom provisions in care homes. Care providers thought she was mad since they believe that the mature clients did not have sex.
A sexual health campaign will reduce the ageism surrounding sex and help reduce the barriers for those seeking sexual health services. SHRH services should have the goal to be as inclusive as possible. It is the utopian dream to see the gay son, sex worker mom and the mature grandfather stud go hand in hand to the sexual health clinic without shame. This will reduce the large pool of ageing late presenters of HIV and it will have the extra benefit that it reduces the impact on health services providing extra care needed for later life.
Sex is healthy and when services can provide healthy sex, then the only problem that needs to be tackled are the multi morbidities that most ageing people with HIV face. However it isn’t that easy according to Giovanni Guaraldi from the University of Moderna. He is convinced that age is the worst predictor of ageing. To cast light on this, there is a difference between ageing people who are recently diagnosed with HIV and those who are ageing with HIV.
Let’s start with a fact: people living with HIV over the age of 45 are 5 times more likely to develop the risk of multi-morbidities than the general population. The root cause seem to originate from fat and lifestyle.
Lipodystrophy remains an issue among the ageing people with HIV. BMI values might be similar to healthy people without HIV but more fat is located near and around the belly. This has a cascade effect that leads to chronic inflammation which can lead to cardio vascular diseases. In turn this can lead to reduced blood flow to the brain having an effect on cognitive functions. In a nutshell these are all the morbidities that most healthcare systems have to deal with when facing ageing people. Add to it ARV with side-effects that can lead to bone loss, liver and kidney problems, add the uncertainties of drug-drug interactions and you have a panicking healthcare provider.
To help the healthcare providers, more investment is needed in inclusive demographic research on the above mentioned health issues. This includes the need for improved matching of control groups for medical trials. However it isn’t only about medicating ageing life; there is a need for cheaper indicator tests for the ageing. Giovanni Guaraldi applied simple strength and balance tests as a frailty indicator. A test for a fatty liver helps assessing the amount of fat around the stomach area.
This is the first step in changing overburdened healthcare systems into approaches that are manageable for healthcare providers and the ageing demographic. Holistic healthcare will have a greater impact in future healthcare systems. So what will that future look like?
“I’m sorry but exercise works!” This is what Marta Boffito from UK Chelsea Westminster hospital states when speaking to ageing people with HIV. We all have our habits but ageing people can be stubborn about changing lifestyles. Especially when it comes to recreational drugs and smoking.
Motivational intervention can work and should be further improved upon as Darren Brown of the UK Chelsea Westminster hospital shows. Darren’s case study showed that people want to improve their body image. People want to be more mobile but frailty and financial uncertainty is a big factor when it comes to ageing people with HIV. Small life lifestyle changes that do not have to impact the quality of life can have positive effects in later life.
For the ageing positive generation to come there are already apps in development that take into account a holistic approach for an ageing person with HIV. Beyou+ is a great example.
These holistic steps will be more important over the coming years when it comes sexual health and care for the ageing positive generation as treatment costs become a bigger burden.
The concluding message that should taken from ageing with HIV is: People can be hypersexual ageing gym bunnies! Isn’t that a future to look forward to?
While these are very basic answers that just skimmed the surface of more complex issues, it can provide some guidance for future policy and care for Europe and beyond. All of the referenced experts gave presentations during the EATG conference on ageing with HIV. EATG has provided all presentations on the Ageing with HIV website and their Facebook page for study and digestion.