Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
Shopping Cart: ( empty )
You are here: Home > Journals > SH > SH08063
RESEARCH ARTICLE
Contents Vol 6(1)

Rapidly ageing HIV epidemic among men who have sex with men in Australia

John M. Murray A B C , Ann M. McDonald B and Matthew G. Law B
+ Author Affiliations
- Author Affiliations

A School of Mathematics and Statistics, University of New South Wales, Sydney, NSW 2052, Australia.

B National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Level 2, 376 Victoria Street, Sydney, NSW 2010, Australia.

C Corresponding author. Email: J.Murray@unsw.edu.au

Sexual Health 6(1) 83-86 https://doi.org/10.1071/SH08063
Submitted: 12 August 2008  Accepted: 15 January 2009   Published: 23 February 2009

Abstract

Background: Antiretroviral therapy has increased survival for individuals living with HIV and has led to an ageing of this population in developed countries. To date the rate of ageing has been unquantified, giving rise to uncertainty in the treatment emphasis and burden in this population. Methods: A mathematical model was used in conjunction with HIV/AIDS data from the Australian National HIV/AIDS Registry to estimate numbers and ages of Australian men who have sex with men (MSM) living with HIV infection from 1980 to 2005. Results: The average age of HIV-infected Australian MSM is estimated to exceed 44 years of age by the year 2010 and has increased by 1 year of age for each two calendar years since the mid-1980s. HIV-infected MSM over 60 years of age have been increasing in number by 12% per year since 1995. A consequence of successful therapy with subsequent ageing of those infected has meant that from 2001 estimated deaths from other causes exceed AIDS deaths in Australia. Conclusions: In summary, our analyses indicate an increasing and rapidly ageing population living with HIV in Australia. This will inevitably lead to more serious non-AIDS conditions in ageing patients living with HIV, and to increased treatment complexity.

Additional keywords: HIV/AIDS, antiretroviral therapy, mortality.


Acknowledgement

We thank B. Donovan and D. Wilson for valuable comments. The National Centre in HIV Epidemiology and Clinical Research is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, The University of New South Wales. Its work is overseen by the Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis. The NCHECR Surveillance Program is a collaborating unit of the Australian Institute of Health and Welfare.


References


[1] Morgan D,  Mahe C,  Mayanja B,  Okongo JM,  Lubega R,  Whitworth JA. HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries? AIDS 2002; 16 597–603.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[2] Lohse N,  Hansen AB,  Pedersen G,  Kronborg G,  Gerstoft J,  Sorensen HT, et al. Survival of persons with and without HIV infection in Denmark, 1995–2005. Ann Intern Med 2007; 146 87–95.
| PubMed |

[3] Van der Paal L,  Shafer LA,  Todd J,  Mayanja BN,  Whitworth JA,  Grosskurth H. HIV-1 disease progression and mortality before the introduction of highly active antiretroviral therapy in rural Uganda. AIDS 2007; 21(Suppl 6): S21–9.
| PubMed |

[4] UNAIDS, North America, Western and Central Europe: AIDS epidemic update regional summary. Geneva: UNAIDS; 2007 .

[5] Shah S,  Mildvan D. HIV and Aging. Curr Infect Dis Rep 2006; 8 241–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[6] Dolcini MM,  Catania JA,  Stall RD,  Pollack L. The HIV epidemic among older men who have sex with men. J Acquir Immune Defic Syndr 2003; 33(Suppl 2): S115–21.
| PubMed |

[7] Dougan S,  Payne LJ,  Brown AE,  Evans BG,  Gill ON. Past it? HIV and older people in England, Wales and Northern Ireland. Epidemiol Infect 2004; 132 1151–60.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[8] Kohli R,  Klein RS,  Schoenbaum EE,  Anastos K,  Minkoff H,  Sacks HS. Aging and HIV infection. J Urban Health 2006; 83 31–42.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[9] National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2007. Sydney: The University of New South Wales; 2007.

[10] Hoare A,  Wilson DP,  Regan DG,  Kaldor J,  Law MG. Using mathematical modelling to help explain the differential increase in HIV incidence in New South Wales, Victoria and Queensland: importance of other sexually transmissible infections. Sex Health 2008; 5 169–87.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[11] Jain SK . Trends in mortality: by causes of death in Australia, the states and territories during 1971–92, and in statistical divisions and sub-divisions during 1991–92. Canberra: Australian Bureau of Statistics; 1994.

[12] Zar JH . Biostatistical analysis. 4th edn. New Jersey: Prentice-Hall; 1999.

[13] National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS, Hepatitis C and Sexually Transmissible Infections in Australia Annual Surveillance Report 1999. Sydney: National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales; 1999.

[14] Silverberg MJ,  Neuhaus J,  Bower M,  Gey D,  Hatzakis A,  Henry K, et al. Risk of cancers during interrupted antiretroviral therapy in the SMART study. AIDS 2007; 21 1957–63.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[15] Carr A,  Grund B,  Neuhaus J,  El-Sadr WM,  Grandits G,  Gibert C, et al. Asymptomatic myocardial ischaemia in HIV-infected adults. AIDS 2008; 22 257–67.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[16] Petoumenos K,  Law MG. Risk factors and causes of death in the Australian HIV Observational Database. Sex Health 2006; 3 103–12.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[17] Lewden C,  Salmon D,  Morlat P,  Bevilacqua S,  Jougla E,  Bonnet F, et al. Causes of death among human immunodeficiency virus (HIV)-infected adults in the era of potent antiretroviral therapy: emerging role of hepatitis and cancers, persistent role of AIDS. Int J Epidemiol 2005; 34 121–30.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[18] Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2005. Volume 17, Rev ed . Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2007.

[19] Manfredi R,  Calza L,  Cocchi D,  Chiodo F. Antiretroviral treatment and advanced age: epidemiologic, laboratory, and clinical features in the elderly. J Acquir Immune Defic Syndr 2003; 33 112–4.
| PubMed |

[20] Hinkin CH,  Hardy DJ,  Mason KI,  Castellon SA,  Durvasula RS,  Lam MN, et al. Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS 2004; 18(Suppl 1): S19–25.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[21] Weber R,  Sabin CA,  Friis-Moller N,  Reiss P,  El-Sadr WM,  Kirk O, et al. Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med 2006; 166 1632–41.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[22] Monforte A,  Abrams D,  Pradier C,  Weber R,  Reiss P,  Bonnet F, et al. HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies. AIDS 2008; 22 2143–53.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[23] Friis-Moller N,  Reiss P,  Sabin CA,  Weber R,  Monforte A,  El-Sadr W, et al. Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med 2007; 356 1723–35.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[24] Friis-Moller N,  Weber R,  Reiss P,  Thiebaut R,  Kirk O,  d’Arminio Monforte A, et al. Cardiovascular disease risk factors in HIV patients – association with antiretroviral therapy. Results from the DAD study. AIDS 2003; 17 1179–93.
| Crossref | GoogleScholarGoogle Scholar | PubMed |