Abstract:
INTRODUCTION:The evolving HIV epidemic, coupled with advances in HIV treatment, has resulted in an ageing HIV-diagnosed population. It has been suggested that adverse physical and psychological effects of HIV may be higher among older people. However, few studies have examined the effect of older age on well-being for people with HIV. MATERIALS AND METHODS:The ASTRA study included 3258 HIV-diagnosed individuals (2248 MSM; 373 heterosexual men; 637 women) recruited from eight UK clinics in 2011-12 (64% response rate). Participants completed a questionnaire that included standard inventories on symptoms and health-related quality of life (HrQoL). Associations of age group with: physical symptom distress (reporting significant distress for ≥1 of 26 symptoms), depression and anxiety (score ≥10 on PHQ-9 and GAD-7, respectively) and HrQoL problem (reporting problems on ≥1 of 5 Eurqol-5D domains) were assessed; adjustment was made for gender/sexuality and time with diagnosed HIV. RESULTS:Of all participants, 87% were taking ART, 76% had VL ≤50c/mL and 19% had CD4 <350/mm(3). Mean age was 45 years (range 18-88) with 5% <30, 23% 30-39, 43% 40-49, 22% 50-59 and 7% ≥60 years. The most prevalent distressing physical symptoms were: lack of energy/tiredness (26%), difficulty sleeping (24%), muscle-ache/joint pain (21%) and pain (18%). With older age, there was no clear trend in prevalence of physical symptom distress, but prevalence of depression and anxiety decreased, while prevalence of HrQoL problems increased. This pattern remained after adjustment for gender/sexuality and time diagnosed with HIV. The increase with age in overall prevalence of HrQoL problem was due to increased problems for "mobility," "self-care" and "performing usual activities" domains, not an increase in "depression/anxiety." Longer time with diagnosed HIV was strongly associated with higher prevalence of all symptoms measures and HrQoL problem (p<0.001 for trend, adjusted models). CONCLUSIONS:Physical and psychological symptoms are common among people living with HIV, but the burden of these symptoms is not highest among the older age group. While HrQoL tended to worsen with older age, physical symptom distress did not, and mental health improved. This may reflect greater resilience in older adults, or the potential for "successful ageing": maintaining mental health despite age-related health losses.
journal_name
J Int AIDS Socjournal_title
Journal of the International AIDS Societyauthors
McGowan J,Sherr L,Rodger A,Fisher M,Miners A,Johnson M,Elford J,Collins S,Hart G,Phillips A,Speakman A,Lampe Fdoi
10.7448/IAS.17.4.19511subject
Has Abstractpub_date
2014-11-02 00:00:00pages
19511issue
4 Suppl 3issn
1758-2652pii
19511journal_volume
17pub_type
杂志文章abstract:BACKGROUND:Diagnosis of primary HIV infection (PHI) has important clinical and public health implications. HAART initiation at this stage remains controversial. METHODS:Our objective was to identify predictors of disease progression among Argentinean seroconverters during the first year of infection, within a multicen...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1186/1758-2652-14-40
更新日期:2011-08-10 00:00:00
abstract:INTRODUCTION:Recent data indicates that low vitamin D (25(OH)D) levels can lead to a worst prognosis in HIV-infected individuals, even in those on successful antiretroviral therapy (ART) [1]. Portugal is the European country that has the largest average sun exposure time but prevalence of hypovitaminosis D is mostly un...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19826
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:HIV prevalence is declining in key populations in Armenia including in people who inject drugs (PWID), men who have sex with men, prison inmates, and female sex workers (FSWs); however, prevalence is increasing among Armenians who seasonally migrate to work in countries with higher HIV prevalence, primaril...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.19.1.20772
更新日期:2016-06-07 00:00:00
abstract:INTRODUCTION:Scientific research has demonstrated the clinical benefits of earlier initiation of antiretroviral treatment (ART), and that ART can markedly reduce HIV transmission to sexual partners. Ensuring universal access to ART for those who need it has long been a core principle of the HIV response, and extending ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.1.19320
更新日期:2014-07-18 00:00:00
abstract::Paediatric antiretroviral treatment (ART) failure is an under-recognized issue that receives inadequate attention in the field of paediatrics and within HIV treatment programmes. With paediatric ART failure rates ranging from 19.3% to over 32% in resource limited settings, a comprehensive evaluation of the causes of f...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.1.20090
更新日期:2015-07-23 00:00:00
abstract:INTRODUCTION:Guidelines regarding antiretroviral therapy (ART) initiation in HIV infection have varied over time, with the 2015 World Health Organization recommendation suggesting ART initiation at the time of diagnosis regardless of CD4 T-cell counts. Herein, we investigated the influence of socio-demographic and clin...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25034
更新日期:2018-02-01 00:00:00
abstract::Potent antiretroviral therapy (ART) reduces mortality and morbidity in people living with HIV by reducing viral load and allowing their immune systems to recover. The reduction in viral load soon after starting ART has led to the hypothesis that early and widespread ART could prevent onward transmission and therefore ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1186/1758-2652-14-S1-S6
更新日期:2011-07-06 00:00:00
abstract:INTRODUCTION:Antiretroviral treatment (ART) has been scaled up over the last decade but compared to adults, children living with HIV are less likely to receive ART. Moreover, children and adolescents are more vulnerable than adults to virological failure (VF) and emergence of drug resistance. In this study we determine...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.19.1.20683
更新日期:2016-04-27 00:00:00
abstract:INTRODUCTION:Recent WHO guidance advocates for early antiretroviral therapy (ART) initiation at higher CD4 counts to improve survival and reduce HIV transmission. We sought to quantify how the cost-effectiveness and epidemiological impact of early ART strategies in India are affected by attrition throughout the HIV car...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.1.20217
更新日期:2015-10-01 00:00:00
abstract:INTRODUCTION:Poor access of lesbian, gay, bisexual and transgender (LGBT) people to healthcare providers with clinical and cultural competency contributes to health inequalities between heterosexual/cisgender and LGBT people. This systematic review assesses the effect of educational curricula and training for healthcar...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.7448/IAS.20.1.21624
更新日期:2017-07-19 00:00:00
abstract:INTRODUCTION:Since June 2016, the national HIV programme in Malawi has adopted Universal Test and Treat (UTT) guidelines requiring that all persons who test HIV positive will be referred to start antiretroviral therapy (ART). Although there is strong evidence from clinical trials that early initiation of ART leads to r...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25239
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:Disruption in bone homeostasis with increased osteoclastic resorption may lead to osteoporosis. HIV tat has been found to increase differentiation of precursor cells into osteoclast (OC) (1). Presence of soluble HIV proteins in virally suppressed HIV patients on ART may drive a bone resorption phenotype. W...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19724
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:Despite recent advances in the management of HIV infection and increased access to treatment, prevention, care and support, the HIV/AIDS epidemic continues to be a major global health problem, with sub-Saharan Africa suffering by far the greatest humanitarian, demographic and socio-economic burden of the e...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.15.2.17422
更新日期:2012-11-21 00:00:00
abstract::Family-based interventions with children who are affected by HIV and AIDS are not well established. The Collaborative HIV Prevention and Adolescent Mental Health Program (CHAMP) represents one of the few evidence-based interventions tested in low-income contexts in the US, Caribbean and South Africa. This paper provid...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.1186/1758-2652-13-S2-S8
更新日期:2010-06-23 00:00:00
abstract:INTRODUCTION:The objective of this commentary is to review considerations for implementing routine viral load (VL) monitoring programmes for HIV-infected infants and children living in low- and middle-income countries (LMIC). Since 2013, the World Health Organization (WHO) guidelines recommend VL testing as the preferr...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25001
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:The Robert Koch Institute (RKI) aimed to assess a molecular surveillance strategy based on filter-dried serum spots (DSS) of all newly diagnosed HIV infections in Germany. In 2013, diagnostic laboratories sent DSS to the RKI representing 55% of the newly diagnosed HIV infections reported to the RKI (protec...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19670
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:The majority of new HIV infections occur through mucosal transmission. The availability of readily applicable and accessible platforms for anti-retroviral (ARV) delivery is critical for the prevention of HIV acquisition through sexual transmission in both women and men. There is a compelling need for devel...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25628
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:Young women aged 15 to 24 years in sub-Saharan Africa continue to be disproportionately affected by HIV. A growing number of studies have suggested that the practice of transactional sex may in part explain women's heightened risk, but evidence on the association between transactional sex and HIV has not y...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,meta分析,评审
doi:10.7448/IAS.19.1.20992
更新日期:2016-11-02 00:00:00
abstract:INTRODUCTION:The long-term effects of an intensified induction regimen are unknown. In this pilot, randomized, prospective study we evaluate the effect of a short-term four-drugs induction regimen in patients with high baseline viral load. METHODS:Naive patients with HIV-RNA>100.000 copies/ml receiving TDF+FTC+EFV+RAL...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19776
更新日期:2014-11-02 00:00:00
abstract:BACKGROUND:This retrospective survey describes types of cancers diagnosed in HIV-infected subjects in Asia, and assesses risk factors for cancer in HIV-infected subjects using contemporaneous HIV-infected controls without cancer. METHODS:TREAT Asia HIV Observational Database (TAHOD) sites retrospectively reviewed clin...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1186/1758-2652-13-51
更新日期:2010-12-10 00:00:00
abstract:INTRODUCTION:Optimal adherence to antiretroviral therapy is closely related with suppression of the HIV viral load in plasma, slowing disease progression and decreasing HIV transmission rates. Despite its importance, the estimated proportion of people living with HIV in Latin America and the Caribbean with optimal adhe...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,meta分析
doi:10.1002/jia2.25066
更新日期:2018-01-01 00:00:00
abstract:INTRODUCTION:Two new microbicide products based on topical (vaginal) application of antiretroviral drugs - 1% tenofovir gel and the dapivirine ring - are currently in late-stage clinical testing, and results on their safety and effectiveness are expected to become available in early 2015. WHO guidelines on the use of t...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.3.19279
更新日期:2014-09-08 00:00:00
abstract:BACKGROUND:In order to maximize the benefits of HIV care and treatment investments in sub-Saharan Africa, programs can broaden to target other diseases amenable to screening and efficient management. We nested cervical cancer screening into family planning clinics at select sites also receiving PEPFAR support for antir...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.15.2.17406
更新日期:2012-06-18 00:00:00
abstract:INTRODUCTION:In 2014 the Joint United Nations Programme on HIV/AIDS defined the ambitious 90-90-90 targets for 2020, in which 90% of people living with HIV must be diagnosed, 90% of those diagnosed should be on sustained therapy and 90% of those on therapy should have an undetectable viral load. Children are considered...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.7448/IAS.18.7.20236
更新日期:2015-12-02 00:00:00
abstract:INTRODUCTION:WHO recommends assisted partner notification (APN) for people living with HIV (PLHIV). These services have not been widely scaled in Central Asia. We describe the results from an APN intervention implemented within a programme focused on PLHIV and people who inject drugs in Kazakhstan, the Kyrgyz Republic ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25313
更新日期:2019-07-01 00:00:00
abstract::[This corrects the article DOI: 10.7448/IAS.20.01/21317.]. ...
journal_title:Journal of the International AIDS Society
pub_type: 已发布勘误
doi:10.7448/IAS.20.1.22066
更新日期:2017-06-02 00:00:00
abstract::Prevention of HIV infection has recently acquired new effective tools, based on the provision of antiretrovirals, to both decrease the "source" of HIV infection and/or to decrease host susceptibility to HIV infection. The milestone concept of using antiretrovirals for prevention has been tested already in the 1990s, t...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19521
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:Global guidelines emphasize the ethical obligation of investigators to help participants in HIV-endpoint trials reduce HIV risk by offering an optimal HIV prevention package. Oral pre-exposure prophylaxis (PrEP) has increasingly become part of state-of-the-art HIV prevention. Here we describe the process o...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,随机对照试验
doi:10.1002/jia2.25491
更新日期:2020-05-01 00:00:00
abstract:INTRODUCTION:Within monocyte-derived macrophages, HIV-1 accumulates in intracellular virus-containing compartments (VCCs) that are inaccessible to the external environment, which implicate these cells as latently infected HIV-1 reservoirs. During mother-to-child transmission of HIV-1, human placental macrophages (Hofba...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.1.19385
更新日期:2015-01-22 00:00:00
abstract:INTRODUCTION:Numerous barriers to optimal uptake of prevention of mother to child transmission (PMTCT) services occur at community level (i.e., outside the healthcare setting). To achieve elimination of paediatric HIV, therefore, interventions must also work within communities to address these barriers and increase ser...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
doi:10.7448/IAS.15.4.17373
更新日期:2012-07-11 00:00:00