Prognosis and outcomes
New UK research suggests that many HIV-positive people have an excellent life expectancy.
Doctors developed a mathematical model based on what is currently known about the effectiveness of HIV treatment and the factors affecting the prognosis of people with HIV.
Their calculations showed that, in ideal circumstances, life expectancy was 78 years.
The model was based on simulated life situations of 10,000 gay men diagnosed with HIV at the age of 30 in 2009.
With timely diagnosis and prompt initiation of HIV treatment, average life expectancy was 75 years. This increased to 78 years if the man didn’t smoke.
Life expectancy was shorter for those who were diagnosed late (i.e. with a low CD4 count), but was still above 71 years.
The researchers estimated that the group was about 50% more likely than people in the general population to develop cardiovascular disease, liver and kidney problems, and cancer.
Therefore, even in ideal circumstances, life expectancy of people with HIV was still poorer than the average UK male life expectancy of 82 years.
Outcomes were calculated for gay men; the researchers suggest that different models need to be developed to calculate the prognosis of other groups affected by HIV.
For more information about the steps you can take to look after your health, visit the healthy living topics pages on our website.
Living with HIV
Separate research has looked at the attitudes and experiences of HIV-positive gay men as they age.
The small study included ten men aged over 50 who received their HIV care at a hospital in London.
All sought to portray themselves as empowered individuals, making the most of the opportunities afforded to them by their improved life expectancy.
However, there were clear differences in experiences and expectations according to whether the men were diagnosed with HIV before or after effective HIV treatment became available in the mid- to late-1990s.
People who were diagnosed before this time tended to be more ambivalent about their future. They often expressed concerns about their financial security. This was largely because they had spent long periods out of work.
Moreover, those with longer-term HIV infection had often experienced illness, side-effects and HIV-related bereavements, and were occasionally socially isolated.
In contrast, those with more recent diagnosis were more likely to regard HIV as “just another chronic disease”, were more financially secure, and were generally more optimistic about the future.
“This study provides some insights into the emerging phenomenon of an ageing HIV population,” conclude the investigators.
There’s a lot of help available if you are experiencing emotional problems or feel socially isolated. A good place to start is NAM’s booklet, HIV, mental health and emotional wellbeing.
HIV care
Several other studies have shown that people who are happy with their care tend to have better outcomes. This could be because they are more comfortable talking to their doctor about their health concerns.
The latest study involved 410 people who started HIV treatment in the late 1990s. Approximately half were satisfied with their care.
People who were in stable housing were almost twice as likely to be happy with their care than those with insecure accommodation.
In addition, satisfaction with care was associated with having a supportive group of friends.
People whose HIV treatment was causing side-effects, as well as those co-infected with hepatitis C, were significantly less likely to be happy with their HIV treatment and care.
The authors conclude that social vulnerability represents a significant barrier to building a satisfying doctor-patient relationship. They suggest doctors should give particular attention to developing productive relationships with people living with difficult social conditions.
Want to work on your relationship with your doctor? Our new online tool, Talking points, helps you prepare a checklist for your next appointment. Visit www.aidsmap.com/talking-points