An important concern in HIV care is the concept of premature, accelerated, or accentuated ageing.  People with HIV may experience some problems associated with ageing at earlier ages than people who do not have HIV, such as frailty, neurocognitive impairment, and osteoporosis.  These concerns have been attributed to the effects of the virus, risk factors (such as smoking, drug use and viral hepatitis) which can confound study interpretations (5) but also to the effects of some antiretroviral medications (6, 7). 

The implications of accelerated or accentuated ageing can be that PLHIV may need additional supports such as home nursing, personal care, respite, and rehabilitation much sooner than is generally the case and when funding arrangements allow (for example, before becoming eligible for aged care services – 65 years in Australia, and 50 years for Aboriginal and Torres Strait Islander peoples).  This is discussed further at the end of this section.