Quality of Life Among Older Adults With HIV: Progress Toward National Goals, 2017–2022

Better HIV treatment has brought longer, healthier lives, and a large and growing share of Americans with diagnosed HIV are now 50 or older. People with HIV are disproportionately affected by adverse social conditions that also affect their health. In 2022, the National HIV/AIDS Strategy set 2025 goals for five quality-of-life indicators. CDC used its Medical Monitoring Project, an annual survey of adults with diagnosed HIV, to check progress among people aged 50 and older.

The goals

By 2025 the strategy aims to:

• raise the share reporting good or better health to 95%; and
• cut by half from baseline the share with unmet need for mental health services (among those who need them), unemployment, hunger or food insecurity, and unstable housing or homelessness.

The data

The Medical Monitoring Project samples 16 states and Puerto Rico and then randomly selects adults with diagnosed HIV from the national surveillance system. This analysis used interviews and medical records from 13,475 people aged 50 and older in the 2017–2022 cycles (collected June 2017–May 2023), with response rates of 40% to 46% among individuals.

Where things stood in 2022

CDC chart from the report: self-rated health and unmet mental health need, with 2025 goals.

Little changed overall. The one goal met by 2022 was halving hunger or food insecurity among people aged 65 and older, the group that saw the largest drop. People 65 and older also fared better than those aged 50–64 on unemployment and, except in 2022, on housing. Symptoms of depression and anxiety among those needing mental health care barely changed, nor did unmet needs for food assistance, meal delivery or housing services. If recent trends continue, the other goals will not be met — though the indicators were adopted only in late 2022, leaving less than two years to act, and a federal implementation plan was still being developed.

What could help

• Health and mental health. People with HIV have poorer physical and mental health than the U.S. population overall. Few adherence programs are designed for older people with HIV, who may juggle many medications and face social isolation. Care that manages chronic disease and disability comprehensively, routine mental health screening, and integrated HIV and mental health care could help.
• Jobs. Skill-building and job-search services tailored to older people with HIV could address barriers such as age-related disability, discrimination and caregiving responsibilities.
• Food and housing. Pandemic-era job losses, and the assistance programs created in response, may have affected trends; reduced unmet need for food assistance may explain the goal met among those 65 and older. Housing may require more effort, such as allocating federal housing resources according to need.

The authors call for a multisectoral approach, beyond clinical care, to improve access to housing, employment, food and mental health care.

Limitations

• Answers may be affected by recall or by a wish to give acceptable answers, though constant biases would not affect trends.
• The estimated annual percentage change is a relative measure, so its size depends on how common each condition is.

Sources

• Linda Beer, Yunfeng Tie, Stacy M. Crim, John Weiser, Jennifer Taussig, Jason A. Craw, Kate A. Buchacz, Ashanté Dobbs, Charles B. Collins Jr., Marie E. Johnston, Andrew De Los Reyes, Deborah Gelaude, Kamal Hughes, Rodel Desamu-Thorpe and Joseph Prejean, "Progress Toward Achieving National HIV/AIDS Strategy Goals for Quality of Life Among Persons Aged ≥50 Years with Diagnosed HIV — Medical Monitoring Project, United States, 2017–2023," Morbidity and Mortality Weekly Report, CDC: https://www.cdc.gov/mmwr/volumes/73/wr/mm7336a1.htm