When the dashing and magnificently bearded Dr. Giovanni Guaraldi took to the stage at last fall’s HIV and Aging conference in New York City, and described a nearly 100-year-old person living with HIV, I was more than a bit skeptical. Not of the researcher—he’s done some of the most brilliant research on aging with HIV. Guaraldi also advocates a "rethink" of care services provided for people living with HIV as we age, particularly now that about half of us are over 50—and by 2030, as many as 40 percent of us will have reached the age of 65.
Rather than our routine HIV care, we increasingly need comprehensive multidisciplinary services to match our more complex needs. Even in middle age, we need a more aggressive approach to screening, diagnosis, and management of many conditions associated with aging.
The firebrand activist Jules Levin of the National AIDS Treatment Advocacy Project (NATAP) has been broadcasting this message for years now—sounding the alarm that we, the aging HIV community, are headed for a services gap. Based upon study after study documenting rates of frailty, aging-related complications, and disability among people living with HIV that are much higher than what is seen in people of the same chronological age in the general population, he believes that HIV care systems are totally unprepared to provide the services many of us will need.
His warnings seem to be falling on deaf ears, due at least partly to ageism and denial. People don’t like to think about all the ailments associated with "growing...

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