Elizabeth Crock: Bolton Clarke HIV Program, Melbourne

Acknowledgments
Jayne Howard: Victorian HIV Service, Alfred Hospital, Melbourne (previous edition) 

This section explores key issues for nurses in relation to ageing and long-term survival with HIV. 

• Ageing with HIV 
• Accelerated or accentuated ageing 
• Long term survival 
• Multiple losses and grief 
• Mental health and resilience 
• Multimorbidities 
• Disability, respite, and long-term care 
• Advance care planning 

Ageing with HIV (See also HIV and Ageing) 

As the life expectancy of people with human immunodeficiency virus (HIV) increases due to successful treatment, more people with HIV are ageing. The average age of people with HIV in Australia is over 45 and the number of people over 60 has been increasing at 12% per year since 1995 (1). The proportion of people over 55 years with HIV was 25.7% in 2010, with a predicted increase to over 44% by 2020 (2, 3).   

Older people living with HIV may be long-term survivors of HIV. However, there are also significant numbers of older people newly diagnosed with HIV.  Between 2018 and 2021, 22% of new HIV diagnoses in Australia occurred in people 50 years and over (3). People diagnosed with HIV when they are over 50 years of age tend to have more advanced disease and experience greater HIV–related illness (4). Older people who are newly diagnosed with advanced HIV disease can have very different needs to those who are long-term survivors (see Nursing implications of late diagnosis – severe disease, treatment, and prevention of opportunistic illnesses).