Clinical Scorecard: Nearly half with HIV may be 65+ by 2040

At a Glance

Key Highlights

• The projected proportion of adults with diagnosed HIV aged 65 years or older rises from 23% in 2025 to 46% in 2040; the estimated number increases from approximately 214,000 to 459,000.
• Median age is projected to increase from 51 to 61 years, while the general adult population's median age in the modeled states remains near 44 years.
• The projected aging pattern varies substantially by state: median age rises to 67 years in California and New York, while it falls to 39 years in Arkansas and Oklahoma.
• The model projects different median-age increases across groups, including 48 to 61 years among Hispanic people with diagnosed HIV and 48 to 57 years among men who have sex with men with diagnosed HIV.
• Projections may change if HIV transmission patterns or survival change; estimates for states with smaller epidemics are less precise.

Guideline-Based Recommendations

Diagnosis

Management

• The authors state that federal and state HIV programs may need to prepare for increased demand for integrated HIV and primary care.
• Planning may need to address cardiovascular and metabolic comorbidities and cognitive, mental, and social health needs.
• The authors indicate that planning should reflect local demographic patterns rather than assume a uniform national pattern.

Monitoring & Follow-up

Risks

• Changes in HIV transmission patterns or survival through 2040 could alter the projections.
• The model assumed uniform transmission mixing within states and estimated individual ages from five broad age categories, introducing uncertainty not fully captured by reported credible intervals.
• Projections for states with smaller HIV epidemics were less precise.

Patient & Prescribing Data

Adults with diagnosed HIV in 24 modeled US states; the study reports projections by age, HIV acquisition risk group, race, and ethnicity.

The article reports no prescribing or treatment-effect data. It describes projected demand for integrated HIV and primary care and services addressing age-related comorbidities and cognitive, mental, and social health needs.

Clinical Best Practices

• Use local demographic patterns when planning services for people aging with HIV, as projected aging differed substantially across states.
• Consider the authors' stated planning needs for integrated HIV and primary care, cardiovascular and metabolic comorbidities, and cognitive, mental, and social health.

Related Resources & Content

• JAMA Network Open modeling study; study title and URL not provided in the source