Projected demographic profile of people living with HIV in Australia: planning for an older generation

James Jansson, David P Wilson, James Jansson, David P Wilson

Abstract

Background: Advances in HIV antiretroviral therapy (ART) has reduced mortality in people living with HIV (PLHIV), resulting in an ageing population of PLHIV. Knowledge of demographic details such as age, geographical location and sex, will aid in the planning of training and resource allocation to effectively care for the future complex health needs of PLHIV.

Methods: An agent-based, stochastic, geographical model was developed to determine the current and future demographic of PLHIV in Australia. Data and parameters were sourced from Australia's National HIV Registry and peer reviewed literature. Processes that were simulated include progression to AIDS, mortality and internal migration.

Findings: The model estimates the mean age of PLHIV in Australia is increasing at a rate of 0.49 years each year. The expected proportion of PLHIV in over 55 years is estimated to increase from 25.3% in 2010 to 44.2% in 2020. Median age is lower in inner-city areas of the capital cities than in rural areas. The areas with the highest prevalence of HIV will continue to be capital cities; however, other areas will have greater percentage growth from 2010 to 2020.

Conclusions: The age of the population of people living with HIV is expected to increase considerably in the future. As the population of PLHIV ages, specialist clinical training and resource provision in the aged care sector will also need to be addressed.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1
Estimated profile of people living with HIV in Australia (a) over time as an age distribution; (b) according to geographical distribution in the year 2020 based on average of the median age.
Figure 2. Comparison of metropolitan and non-metropolitan…
Figure 2. Comparison of metropolitan and non-metropolitan population change by jurisdiction.
Only states that had separate statistical region definitions for metropolitan/non-metropolitan areas were included.
Figure 3
Figure 3
Prevalence of diagnosed HIV in Australia by statistical region in the year (a) 2000 and (b) 2020.
Figure 4. Proportion of PLHIV who are…
Figure 4. Proportion of PLHIV who are female by year and state/territory.
The thick black curve represents all of Australia.

References

    1. Hammer SM, Saag MS, Schechter M, Montaner JS, Schooley RT, et al. (2006) Treatment for adult HIV infection: 2006 recommendations of the International AIDS Society-USA panel. JAMA 296: 827–843.
    1. Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, et al. (1998) Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 338: 853–860.
    1. Mills EJ, Rammohan A, Awofeso N (2011) Ageing faster with AIDS in Africa. Lancet 377: 1131–1133.
    1. Australian Institute of Health and Welfare (AIHW) (2010) GRIM (General Record of Incidence of Mortality) Books. Canberra. AIHW.
    1. Biggar R, Kirby K, Atkinson J, McNeel T, Engels E (2004) Cancer risk in elderly persons with HIV/AIDS. JAIDS Journal of Acquired Immune Deficiency Syndromes 36: 861.
    1. Wyatt CM, Winston JA, Malvestutto CD, Fishbein DA, Barash I, et al. (2007) Chronic kidney disease in HIV infection: an urban epidemic. AIDS 21: 2101–2103 2110.1097/QAD.2100b2013e3282ef2101bb2104.
    1. Friis-Møller N, Weber R, Reiss P, Thiébaut R, Kirk O, et al. (2003) Cardiovascular disease risk factors in HIV patients - association with antiretroviral therapy. Results from the DAD study. AIDS 17: 1179–1193.
    1. Bica I, McGovern B, Dhar R, Stone D, McGowan K, et al. (2001) Increasing Mortality Due to End-Stage Liver Disease in Patients with Human Immunodeficiency Virus Infection. Clinical Infectious Diseases 32: 492–497.
    1. Cole JW, Pinto AN, Hebel JR, Buchholz DW, Earley CJ, et al. (2004) Acquired Immunodeficiency Syndrome and the Risk of Stroke. Stroke 35: 51–56.
    1. Mallitt K-A, HIV incidence trends by Australian jurisdiction reveal a marked rise in Queensland: An extended back-projection analysis of men who have sex with men; 2011; Canberra.
    1. Hallett TB, Gregson S, Dube S, Mapfeka ES, Mugurungi O, et al. (2011) Estimating the resources required in the roll-out of universal access to antiretroviral treatment in Zimbabwe. Sexually Transmitted Infections
    1. Murray JM, McDonald AM, Law MG (2009) Rapidly ageing HIV epidemic among men who have sex with men in Australia. Sexual Health 6: 83–86.
    1. Australian Bureau of Statistics (ABS) (2006) Statistical Geography Volume 1 - Australian Standard Geographical Classification (ASGC). Canberra: ABS.
    1. Mellors JW, Munoz A, Giorgi JV, Margolick JB, Tassoni CJ, et al. (1997) Plasma Viral Load and CD4+ Lymphocytes as Prognostic Markers of HIV-1 Infection. Annals of Internal Medicine 126: 946–954.
    1. Hull P, Holt M, Mao L, Kao S, Prestage G, et al. (2011) Gay Community Periodic Survey: Sydney February 2011. National Centre in HIV Social Research, The University of New South Wales.
    1. Grierson J, Power J, Pitts M, Croy S, Clement T, et al. (2009) HIV Futures 6: Making Positive Lives Count, monograph series number 74,. The Australian Research Centre in Sex, Health and Society, Latrobe University, Melbourne, Australia.
    1. Nakhaee F, Black D, Wand H, McDonald A, Law M (2009) Changes in mortality following HIV and AIDS and estimation of the number of people living with diagnosed HIV/AIDS in Australia, 1981–2003. Sexual Health 6: 129–134.
    1. National Centre in HIV Epidemiology and Clinical Research (2010) HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report. National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW.
    1. Negin J, Mills EJ, Albone R (2011) Continued neglect of ageing of HIV epidemic at UN meeting. Lancet 378: 768.
    1. Negin J, Cumming RG (2010) HIV infection in older adults in sub-Saharan Africa: extrapolating prevalence from existing data. Bull World Health Organ 88: 847–853.
    1. Justice AC (2010) HIV and aging: time for a new paradigm. Curr HIV/AIDS Rep 7: 69–76.
    1. Stewart RB, Cooper JW (1994) Polypharmacy in the Aged: Practical Solutions. Drugs & Aging 4: 449–461.
    1. Teweldemedhin E, Marwala T, Mueller C. Agent-based modelling: a case study in HIV epidemic;. 2004 5–8 Dec. 2004 154–159.
    1. Hallett TB, Gregson S, Mugurungi O, Gonese E, Garnett GP (2009) Assessing evidence for behaviour change affecting the course of HIV epidemics: A new mathematical modelling approach and application to data from Zimbabwe. Epidemics 1: 108–117.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner