Negative Lifestyle Factors Specific to Aging Persons Living with HIV and Multimorbidity

The primary goal of medical care during the pre-antiretroviral therapy (ART) era was to keep persons living with human immunodeficiency virus (HIV) alive, whereas since the advent of ART, the treatment objective has shifted to decreasing viral loads and infectiousness while increasing CD4+ T-cell counts and longevity. The health crisis, however, is in preventing and managing multimorbidity (ie, type 2 diabetes), which develops at a more accelerated or accentuated pace among aging persons living with HIV. Relative to the general population and age-matched uninfected adults, it may be more difficult for aging HIV-positive persons who also suffer from multimorbidity to improve negative lifestyle factors to the extent that their behaviors could support the prevention and management of diseases. With recommendations and a viable solution, this article explores the impact of negative lifestyle factors (ie, poor mental health, suboptimal nutrition, physical inactivity, alcohol use) on the health of aging individuals living with HIV. How Negative Lifestyle Factors Impact Aging Persons Living with HIVThis literature review highlights negative lifestyle factors experienced by aging persons living with HIV, including poor mental health (i.e., depression, cognitive decline), poor nutrition, physical inactivity, alcohol use, sexually transmitted infection, poor sleep quality, and treatment noncompliance as promoting diseases (e.g., type 2 diabetes, hypertension, obesity, cardiovascular disease) and early death. A possible solution to decreasing or eliminating negative lifestyle factors in the aging HIV-positive population is to develop disease prevention-focused teams in clinical and community settings. However, if team development is impractical, primary healthcare providers should routinely assess and monitor lifestyle factors (i.e., cognitive decline) and, if needed, provide appropriate referrals to licensed or certified specialists (e.g., psychologist, clinical dietitian, medical exercise specialist, or health coach).