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Ryan White's Aging Workforce

The dedicated medical providers at Ryan White HIV/AIDS Program-funded clinics have been delivering HIV primary care for over two decades; they, too are aging with the HIV epidemic.30 Their experience is invaluable. Nurse practitioners and physician assistants with HIV expertise provide care that is considered to be superior to that provided by nonspecialist physicians.31 Many of these providers will be retiring in the coming years, without a sufficient number of experienced providers to replace them.

The very purpose of the Living History Web Site is to compile information about the epidemic and HRSA’s history addressing it. HRSA’s AIDS Education and Training Centers (AETCs) have also been working to educate new HIV providers as well as primary care providers around the issues of HIV. In addition, HRSA held a stakeholder meeting to identify workforce shortage issues and how best to address them. One innovation has been the HRSA-funded Health Workforce Information Center. (To read about these efforts and others, see the HRSA CAREAction newsletter on workforce capacity and HIV available as a PDF here.)

Now, Ryan White providers are helping perinatally infected young adults start their own families. “Our kids have a new generation of children,” says Ana Garcia. “I’ve started a custom; the girls bring in their ultrasounds, and I put them together with photos of them with their babies. It is so wonderful to see these kids grow up and have a chance to have HIV-negative babies.”

Growing Older with Ryan White

The HIV epidemic in the United States is maturing. People are living longer, and acquiring HIV later in life. In 2010, 8,074 of the estimated 48,298 new HIV diagnoses were in people age 50 and older.28 By 2015, one-half of all PLWHA in the United States will be over 50 years of age.29 Ryan White grantees and providers are reaching clients who reflect the age-specific demographics of the HIV epidemic. In 2010, 50 percent of Ryan White HIV/AIDS Program clients were age 45 or older.

In 1984, we were watching people die. Now, people are aging with HIV disease. The paradigm has shifted: It’s not just about CD4 cell count and viral load. Ryan White medical providers have gone back into their bag of tricks, to manage all of the things that come with aging—and HIV. Their patients are not 25 years old anymore; they are 55 years old.

—Diana Travieso Palow, Chief HIV Education Branch,
Division of Training and Technical Assistance, HIV/AIDS Bureau/HRSA

Photo of older woman with a stethoscope listening to the heart of an older man.

Many people over 50 years of age have been living with HIV/AIDS for decades, while others are newly infected or recently diagnosed. Regardless of the duration of their HIV infection, these older adults are especially vulnerable to comorbidities associated with aging, such as cardiovascular, renal and liver disease; diabetes; hypertension; lipid abnormalities; non-AIDS related malignancies; frailty; bone loss; and dementia. Ryan White grantees and providers have risen to the challenge of caring for people living—and aging—with HIV.

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