The aging of the population is a continually new element in long-term care for HIV; breakthrough antiretroviral therapy (ART) and other virus suppressing agents available in standard practice have provided patients with a longer lifespan. As a result, HIV / AIDS clinicians constantly encounter increasingly older patients with chronic disease.
With this positive development comes the caveat that hangs over most chronic disease patients, explained Ellen Eaton, MD at Contagion.
“Our population is aging, and like them, they collect comorbidities just like our HIV negative population,” she said. “We see depression, anxiety, and other things like diabetes and high blood pressure.”
And with the introduction of a potentially fatal and life-changing viral pandemic, these risks of co-morbidity in the high-risk HIV population are even more psychosocial: depression, suicidal ideation and substance abuse disorders, among others.
In an interview with Contagion During IDWeek 2021, Eaton, from the University of Alabama at Birmingham, discussed his presentation topic at the Annual Meeting on Infectious Diseases: The Multifactorial Burdens of People Living with HIV During the COVID-19 Pandemic .
As Eaton explained, the unique population faces more barriers to treatment, a higher rate of unhealthy behaviors and addictions due to the stressors of the pandemic – and all of these are piling up in the body. risk of worsening control of their HIV. On top of all this, many HIV clinics have been forced to work remotely during epidemics, compromising patients’ direct access to care.
“It really is the perfect storm for more HIV transmissions,” Eaton said. “It’s the perfect storm for things like suicide and overdose.”
Eaton also spoke about some positive developments for the HIV community during COVID-19: Telemedicine has been adopted by a slice of patients, and relaxed policies for opioid use disorders have allowed more beneficial prescribing for people at risk.
But it is both the burdens and the positives that clinicians must take away from the pandemic to better inform the response to the next big societal problem that could have a unique impact on the HIV community.
“What we do know is that we will probably see more ripples and waves of COVID-19 – and if not COVID, we know that every few years or so we are subjected to different public health issues, societal turmoil, to other issues that can disrupt our traditional brick and mortar clinics, ”Eaton said.