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By Brian Altman, Deputy
Director, Administration on Aging, ACL
September 18th marks National HIV/AIDS and Aging Awareness
Day—a day we celebrate the growing number of people living
long and active lives with HIV. When HIV emerged in the
early 1980s, people who contracted the virus could expect
to live only a few years with their diagnosis. Thanks to
advances in treatment, people who are 50 and older, many of
whom have been living with HIV for decades, are a large and
growing population. Research
has shown that people with HIV who are successfully treated
with antiretroviral therapy can have a lifespan similar to
that of their HIV negative peers, living well into their
70s and 80s. Currently, over
half of adults living with HIV are over the age of 50,
and by 2030 over 70 percent of the HIV positive population
in the United States will
be over 50; older people of color are disproportionately
affected by HIV, as are older men who have sex with
men.
September 18th is also a day to raise awareness of the
aging-related health and social service needs of older
adults living with HIV. They are an extremely
diverse population with distinct needs that will
continue to evolve as they age.
With its extensive experience providing services to meet
the need of a growing, and increasingly diverse,
population, ACL’s aging network plays an important role in
the lives of older adults across the country. Armed with
the array
of programs funded by ACL to help older adults stay
healthy, active, and living in their communities, the
network is helping support the healthy aging of people
living with HIV. For example:
OAA Health and Wellness
Programs
Most programs and services provided by the aging network
can be beneficial for people aging with HIV, but a few,
such as the Positive
Self-Management Program (PSMP) developed at Stanford
University more than 20 years ago, are specifically
designed for people living with HIV. With a grant
from ACL under the OAA Chronic
Disease Self-Management Education program, the Central
Maine AAA recently began working with MaineGeneral Health’s
Horizon Program to implement PSMP for older Mainers with
HIV..
Programs don’t need to be specifically focused on HIV –
many of ACL’s health and wellness programs can be tailored
to the needs of older adults living with HIV. Open
Hand Atlanta is offering chronic disease
self-management education to people living with HIV in
conjunction with their signature nutrition
and education programs and services. The Council
for Jewish Elderly in Illinois, a 2021 recipient of a
falls-prevention grant from ACL, is implementing two
programs that will reach over 1,300 older people in
Illinois and New York living with HIV and/or in low-income,
minority, and LGBTQ+ communities.
Insurance
Counseling
ACL programs help people living with HIV access critical
insurance to pay for medical care and medication. State
Health Insurance Assistance Programs (SHIPs) provide
counseling and guidance to help people navigate complex
enrollment and benefits decisions in Medicare and other
health insurance programs.
SHIPs
also are collaborating with other HIV service providers to
meet the needs of people aging with HIV. For example, many
people living with HIV who become eligible for Medicare due
to age or disability are also eligible for the Ryan
White program, which provides health care and
supportive services to moderate-income individuals living
with HIV. Coordination of benefits issues can arise when
someone receiving Ryan White services becomes eligible for
Medicare or other insurance programs and participates in
multiple programs simultaneously.
The staff and volunteers of the Iowa SHIP participated in
cross training with the state’s Ryan White program grantees
to improve their ability to address these complex benefits
questions and better meet the needs of people participating
in both programs.
New
State Plan Guidance
ACL recently updated its State
Plan Guidance, which provides instructions for states
to follow when developing their multi-year state aging
services plans and details target populations that should
be a focus of each state. For the first time, this guidance
requests that states include a description of strategies to
serve older adults living with HIV, as well as the
objectives and measures (data elements and sources) the
state will use to demonstrate progress.
The State Plan Guidance applies to plans developed and
submitted to ACL starting in 2022, but some states are
leading the way. Illinois
and California included efforts targeting older adults
with HIV for aging services in the plans they submitted in
2021.
Support
for the Aging Network
To ensure inclusivity and cultural competency, ACL funds a
number of resource
centers dedicated to providing support and guidance to
grantees on how to best serve the needs of diverse older
adults and people with disabilities. One example is the National
Resource Center on LGBTQ+ Aging, which includes resources
and training
for ACL network partners serving older adults with HIV.
The reach of the ACL aging
network allows it unique access to address the health and
social support needs of older adults living with HIV, and
ACL’s programs provide powerful tools to support them in
healthy aging. On this day of observance and celebration,
we should also look to the future and develop creative and
sustainable ways to best serve the diverse populations of
older adults in our communities, which include an
increasing number of people aging with HIV.
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