The third decade of the HIV/AIDS epidemic in the United States presents many challenges for health care providers in the diagnosis and management of HIV disease. The changing demographic of patients is one, as the number of older Americans who are living with and becoming infected with HIV is increasing. A disease once found almost exclusively among younger persons is now being recognized as an important public health concern among older adults. The advent and success of highly active antiretroviral therapy (HAART) is allowing patients infected with HIV to live longer and therefore grow older. This presents an interesting scenario, as many AIDS-related conditions such as cognitive impairment and metabolic changes are also associated with advanced age. This review examines the differences in epidemiologic patterns of HIV between older and younger populations, discusses the different states of disease in aging patients, and presents goals for caring for older patients who are either infected or at risk for becoming infected with HIV.

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