HIV and Africa's elderly:  the problems and possibilities.
Demographic changes and the increasing availability and coverage of antiretroviral therapy imply that the burden of HIV is shifting to older age groups in sub-Saharan Africa. However, very little is known about the burden of disease and the unique considerations required to adequately treat and retain older Africans. In this review, we summarize the epidemiological data on HIV prevalence among older Africans, and review progress and barriers to accessing treatment and care. The unique clinical considerations distinguishing the management of older HIV-infected Africans are summarized, with a focus on cardiovascular disease, neuropsychiatric conditions, oncologic illness, and musculoskeletal morbidity. The review concludes by suggesting opportunities for improving our knowledge about and management of HIV among older Africans, including prevention opportunities and potential technologies, including a polypill for reducing comorbidity in this under-recognized highly vulnerable group.
Division of General Medical Disciplines, Stanford University, Stanford, California 94305, USA. ebd@stanford.edu
Eran
E
Bendavid
Nathan
N
Ford
Edward J
EJ
Mills
D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D000375:Aging; D019380:Anti-HIV Agents / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000453:epidemiology*; D010024:Osteoporosis / Q000453:epidemiology*; D015995:Prevalence; D018571:Sentinel Surveillance
D019380:Anti-HIV Agents