A recent study published in The Lancet Healthy Longevity identifies a concerning trend: the acquisition of HIV among older adults, particularly in sub-Saharan Africa, is on the rise, yet prevention and treatment campaigns remain largely focused on younger demographics. This oversight presents significant public health implications, as individuals aged 50 and over now comprise an increasing proportion of people living with HIV.

Rising Prevalence Among Older Adults

Data indicates that from 2000 to 2016, the number of adults aged 50 years and older living with HIV in sub-Saharan Africa has doubled. Currently, the prevalence of HIV among older adults exceeds that of younger populations.

By the year 2040, it is projected that one-quarter of individuals with HIV in Africa will be aged 50 years and older. This evolving demographic landscape underscores the urgent need for targeted awareness and treatment initiatives focused on older generations. Dr. Luicer Olubayo, a key researcher from the Sydney Brenner Institute for Molecular Bioscience (SBIMB), emphasized the misconceptions surrounding HIV acquisition. He noted, "We often think of HIV as a disease of younger people. It doesn't help that intervention campaigns are mainly targeted at the youth."

Misperceptions and Stigma

Another significant barrier to effective HIV management among older adults is the misconception that they are not at risk. This pervasive belief hampers efforts to meet global health objectives such as the UNAIDS' 95-95-95 targets by 2030, which aim for:

  • 95% of people living with HIV to know their status
  • 95% of those who know their status to be on treatment
  • 95% of those on treatment to have a suppressed viral load

Associate Professor F. Xavier Gómez-Olivé from the MRC/Wits-Agincourt Research Unit stated, "While HIV prevalence among individuals over 50 years of age is similar to or even exceeds that of younger adults, HIV surveys focus on younger individuals, leaving considerable gaps in understanding HIV prevalence, incidence, and treatment outcomes in older populations."

Barriers to Testing and Treatment

Low rates of HIV testing among older adults greatly impede timely diagnosis and access to necessary care. Stigma continues to surround HIV, contributing to a reluctance to seek testing. Dr. Olubayo highlighted, "Understanding HIV-related stigma in older adults remains crucial as a way to inform interventions that support older people's mental health and overall well-being."

Interventions for older adults should include:

  • Repeating HIV testing
  • Utilizing pre-exposure prophylaxis (PrEP)
  • Increasing awareness and reducing infections among the elderly

HIV can be managed alongside non-communicable diseases like hypertension, diabetes, and obesity, which have seen staggering increases among older populations in sub-Saharan Africa.

Complex Interplay of Risk Factors

The study further emphasizes that age, education level, gender, and geographical location play pivotal roles in shaping the risk of HIV among older adults. Alarmingly, widowed women showed the highest rates of HIV (30.8%), potentially owing to loss of partners, stigma, and increased vulnerability to risky behaviors such as transactional sex. Additionally, individuals with low education and income levels are at a heightened risk.

Longitudinal Insights and Their Importance

This research provides crucial longitudinal data on the evolving HIV epidemic among older adults in sub-Saharan Africa, addressing the gap in knowledge regarding this demographic's experiences and outcomes over time. Gómez-Olivé notes, "With longitudinal data, we can look at the effectiveness of antiretroviral therapy coverage in older people."

Research Details

This critical study utilized data from urban Kenya and assorted urban and rural locations across South Africa, gathered during two collection waves from 2013–2016 and 2019–2022. Over the course of a decade, researchers have gained a deeper understanding of this aging HIV epidemic, filling significant research gaps and uncovering essential insights.

Conclusion

The findings highlight the need for tailored HIV interventions that specifically address the needs of older adults while breaking down the stigma associated with the disease. This approach can facilitate better health outcomes, promoting both the mental and physical well-being of older populations living with HIV.

For further information: Olubayo, L. A. I., et al. (2025). The prevalence, incidence, and sociodemographic risk factors of HIV among older adults in sub-Saharan Africa (AWI-Gen): a multicentre, longitudinal cohort study, The Lancet Healthy Longevity.

Related Article: Retrieved from Medical Xpress.

References

[1] Olubayo, L. A. I., et al. (2025). The prevalence, incidence, and sociodemographic risk factors of HIV among older adults in sub-Saharan Africa. The Lancet Healthy Longevity.

[2] Gómez-Olivé, F. X., et al. (2025). Challenges in HIV Epidemiology Among Older Adults. MRC/Wits-Agincourt Research Unit.

[3] UNAIDS. (2020). Global AIDS Update 2020.