The Sixth National HIV Strategy

6.3.1 Emerging issues

Page last updated: July 2010

Ageing of the overall population of people living with HIV is giving rise to new challenges. Effects of ageing can be accelerated by HIV and the diseases of ageing can be made more complex by HIV treatments. Many who leave the workforce experience problems associated with living on a fixed retirement or pension income combined with the added costs of chronic illness.

People who have been living with HIV for a long time have different needs to those newly diagnosed, especially regarding management of therapies. Changes in the morbidity profile of HIV require a focus on the aged care system and on mental health and wellbeing. Serious non-acquired immunodeficiency syndrome morbidities (e.g. cardiovascular and renal disease, cancers) occur at increased rates in people living with HIV and cause an increasing proportion of morbidity and mortality. Co-morbidities demand adjustments to HIV clinical services and research.

Avenues for improving access for people living with HIV and determining the best practice models for service delivery across HIV specific and mainstream long-term support services, including aged care services require consideration and should be progressed in consultation with people living with HIV, through advocacy and workforce development initiatives in partnership with the relevant commonwealth, state and territory departments.

A range of health conditions can be prevented, their onset delayed and their management improved through early preventative and curative healthcare services delivered long-term in the community. It is important that people living with HIV be encouraged to participate in preventative health promotion programs focusing on improved diet and nutrition, regular exercise, smoking cessation, reduced alcohol and other drug intake, and regular monitoring and screening. A positive health promotion and awareness framework conducted by mainstream organisations should be complemented and reinforced by targeted efforts offered by HIV community-based organisations.

Top of Page

Health promotion programs should encompass: treatment (including national guidelines on the prevention and treatment of co-infections and co-morbidities); side effect management; health maintenance including sexual health, effective STI testing and treatment; smoking cessation; reducing cardiac risk factors; vaccination for hepatitis B; education in relation to hepatitis C prevention, particularly for HIV-positive gay men and people who inject or have injected drugs; chronic disease self-management and strategies to address depression and anxiety; peer support; social connectedness; and workplace policies and occupational programming to support people living with HIV to remain in or re-enter the workforce.

While the number of children with HIV infection in Australia is small12, the provision of adequate specialist paediatric services is important. Adolescents who have grown up living with HIV have specific care and support needs.

12 National Centre in HIV Epidemiology and Clinical Research, ‘HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia’, Annual Surveillance Report 2009, National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney NSW, 2009.