Table of ContentsView AllTable of ContentsLife Expectancy TodayHow to Live LongerBarriers to LongevityAging With HIVLate DiagnosesAvoiding ComplicationsHow to Find Support
Table of ContentsView All
View All
Table of Contents
Life Expectancy Today
How to Live Longer
Barriers to Longevity
Aging With HIV
Late Diagnoses
Avoiding Complications
How to Find Support
People with HIV can expect to live a near-normal life expectancy if diagnosed and treated early. With advances inantiretroviral therapy, people living with HIV can expect to live longer and healthier than ever before if treatment is started at the time of diagnosis and taken as prescribed.
With that said, many factors can take back those gains and shorten a person’s life expectancy. Some you can change, such as smoking and injecting drugs, and some you can’t, like race and gender.
At the same time, non-HIV-related conditions like diabetes, heart disease, and cancer are more common in people with HIV. This makes it all the more important to reduce your risk for those diseases in order to live a longer, more healthy life.
Changes in Life Expectancy With HIV
Whenhighly active antiretroviral therapy (HAART)was first introduced in 1996, the average life expectancy of a 20-year-old newly infected with HIV was 10 years from the time of diagnosis.This new drug strategy—which involved the combination of multiple drugs of different classes—proved so effective that death rates rapidly dropped and life expectancies rapidly increased.
According to a 2013 study from the North American AIDS Cohort Collaboration on Research and Design, a 20-year-old starting HIV therapy could expect to live to their early 70s.
That figure was confirmed in a 2023 review published inLancet HIVin which the average life expectancy was reported to be anywhere from 70.8 years to 74.6 years for a 20-year-old newly diagnosed with HIV in North America and Europe.
With the life expectancy of the general U.S. population hovering at 77 years, this means that people treated early for HIV can enjoy near-normal lifespans. Some individuals can expect to live even longer.
How to Increase Life Expectancy
There are four things you can do to live a long, healthy life if recently diagnosed with HIV:
Delayed Treatment Reduces Longevity
Factors That Affect Life Expectancy
Despite advances in diagnosis and treatment, there are factors that can increase or decrease the life expectancy of people living with HIV. They include:
How HIV Affects You as You Age
With age, health concerns about HIV extend beyond just HIV-related illnesses. Even if HIV treatment is successful, the risk of non-HIV-associated diseases is exponentially greater than that of the general population.
So serious are these concerns that a person living with HIV today is far more likely todie prematurelyof a non-HIV-related illness than an HIV-related one.
That said, HIV infection may increase your risk of:
Drug-Induced Kidney and Bone DiseaseIt is important to note that certain antiretroviral drugs are associated with an increased risk of kidney dysfunction and osteoporosis. Chief among these is tenofovir found in the drugsTruvada, Descovy, Viread, Complera, Stribild, Atripla, Delstrigo, Symfi, and Symfi Lo.It is for this reason that people on tenofovir need to have their blood routinely checked withkidney function tests.Males 50 and older, postmenopausal females, and people at high risk of falls should undergo abone scanand discontinue tenofovir use if bone loss is significant.
Drug-Induced Kidney and Bone Disease
It is important to note that certain antiretroviral drugs are associated with an increased risk of kidney dysfunction and osteoporosis. Chief among these is tenofovir found in the drugsTruvada, Descovy, Viread, Complera, Stribild, Atripla, Delstrigo, Symfi, and Symfi Lo.It is for this reason that people on tenofovir need to have their blood routinely checked withkidney function tests.Males 50 and older, postmenopausal females, and people at high risk of falls should undergo abone scanand discontinue tenofovir use if bone loss is significant.
It is important to note that certain antiretroviral drugs are associated with an increased risk of kidney dysfunction and osteoporosis. Chief among these is tenofovir found in the drugsTruvada, Descovy, Viread, Complera, Stribild, Atripla, Delstrigo, Symfi, and Symfi Lo.
It is for this reason that people on tenofovir need to have their blood routinely checked withkidney function tests.Males 50 and older, postmenopausal females, and people at high risk of falls should undergo abone scanand discontinue tenofovir use if bone loss is significant.
Quality of Life
Even with newer drugs offering fewer side effects and simpler dosing schedules, people living with HIV still face significant challenges over the long term.
Even with excellent adherence, antiretroviral therapy can eventually fail and require a whole new set of drugs, some of which may be less tolerable. The cost of ongoing care and treatment can cause financial burdens and undue stress.
Moreover, the impact of stigma—which affects 82% of people living with HIV—can lead to social isolation that reduces not only the quality of life but also the ability to adhere to treatment.
Dealing with these concerns is seen to be just as important as getting a viral load to undetectable levels.
HIV Diagnosis in Older Adults
Older adults are more likely than younger adults to be diagnosed with HIV in the late stages of the disease,often when theimmune system is compromisedand the CD4 count is below 200 (theclinical definition of AIDS). For many in this situation, the diagnosis is made only after a person has had their first major opportunistic infection.
The problem with this is that older age and a low CD4 count at the time of diagnosis decrease the odds of restoring your CD4 count to normal levels. This, in turn, can affect your long-term survival.
Because HIV is often symptom-free until severe illness occurs, the U.S. Preventive Services Task Force recommends the once-off testing of HIV for all Americans ages 15 to 65 as part of a routine medical visit.
Testing is especially crucial if you haverisk factors for HIV, such as a history of multiple sex partners, condomless sex, or injection drug use.
Late Diagnoses in Older AdultsAccording to a 2023 report from the Centers for Disease Control and Prevention, 34% of people aged 55 and older already had late-stage HIV infection (AIDS) at the time of their diagnosis.
Late Diagnoses in Older Adults
According to a 2023 report from the Centers for Disease Control and Prevention, 34% of people aged 55 and older already had late-stage HIV infection (AIDS) at the time of their diagnosis.
Reducing the Risk of Developing AIDS
The best way to avoid a diagnosis of AIDS is to start antiretroviral therapy. This involves two or more drugs used in combination that block stages in the virus' life cycle. By doing so, the virus cannot make copies of itself, and the viral population can be reduced to undetectable levels where it can do the body little harm.
Most antiretroviral therapies come in pill form. Many are fixed-dose combination drugs that combine multiple antiretrovirals, reducing your dose to as little as one pill per day.
Dosing has even been made simpler with the introduction ofCabenuva, an antiretroviral therapy requiring two injections in the buttocks every two months.
Even if your diagnosis is delayed, it still benefits your health and longevity to start treatment immediately. If your CD4 count is low, your healthcare provider can prescribeprophylactic (preventive) drugsthat help reduce the risk of different opportunistic infections.
How Long Can I Live Without Treatment?According to a 2021 study in theJournal of the International AIDS Society,the average life expectancy for an untreated 24-year-old with HIV is 12.5 years, and 7.2 years for an untreated 45-year-old with HIV.Once AIDS is diagnosed, an untreated person will live for approximately three years.Fortunately, with appropriate treatment, a person with HIV may never develop AIDS or severe HIV-related complications.
How Long Can I Live Without Treatment?
According to a 2021 study in theJournal of the International AIDS Society,the average life expectancy for an untreated 24-year-old with HIV is 12.5 years, and 7.2 years for an untreated 45-year-old with HIV.Once AIDS is diagnosed, an untreated person will live for approximately three years.Fortunately, with appropriate treatment, a person with HIV may never develop AIDS or severe HIV-related complications.
According to a 2021 study in theJournal of the International AIDS Society,the average life expectancy for an untreated 24-year-old with HIV is 12.5 years, and 7.2 years for an untreated 45-year-old with HIV.Once AIDS is diagnosed, an untreated person will live for approximately three years.
Fortunately, with appropriate treatment, a person with HIV may never develop AIDS or severe HIV-related complications.
How to Get Support
Ensuring the longest possible life with HIV requires a commitment to therapy. This means taking your pills every day, making sure your prescriptions are refilled, and staying linked to consistent medical care.
These include:
It also helps to build a network of friends and confidants to support you or to join anHIV support groupavailable online or in person.
Summary
Studies show that people living with HIV today can expect to live a near-normal life expectancy if treatment is started early and taken every day as prescribed. Even so, some factors can undermine a person’s ability to do so.
Poverty, stigma, and racism can stand in a person’s way of accessing care and treatment. Other behaviors like smoking and injecting drug use are directly linked to a loss of life years.
Delayed treatment also reduces life expectancy because the immune system is less likely to recover, leaving the body vulnerable to infection.
Starting treatment early, staying on treatment, seeing your healthcare provider regularly, and maintaining a healthy lifestyle contribute to living a long life with HIV.
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