Publications
The Impact of Age and Age-related Factors on Viral Suppression Among People Living with HIV
2026
Brennan Ing, M., Kaufman, J., Manalel, J, & Ernst, J. (2026, July 7). The impact of age and age-related factors on viral suppression among people living with HIV [Poster presentation]. IAGG World Congress, Amsterdam.
Mark Brennan Ing, Jennie Kaufman and Jasmine Manalel
Abstract
Background: People 50 and older are the majority of people living with HIV (PLWH) in the U.S. and in other high-income countries. Undetectable HIV viral load is associated with better clinical outcomes and nearly zero risk of HIV transmission through sex. We have little information about how the challenges of aging with HIV (multimorbidity, polypharmacy) affect maintaining viral suppression among older PLWH 50.
Methods: Health claims data for 2,677 PLWH who were continuously enrolled in a managed care plan from 2016 through 2019 and had viral suppression data in their claims records were extracted and de-identified. Cluster analysis classified PLWH into five viral suppression patterns (consistently suppressed, fluctuated, became suppressed, became unsuppressed, consistently unsuppressed). Multinomial logistic regression examined associations of age and age-related factors to viral suppression patterns.
Results: PLWH who were older had greater odds of consistent viral suppression. Polypharmacy was not a significant covariate due in part to the high average number of medications regardless of age. However, multimorbidity was strongly associated with viral suppression patterns in a nearly linear fashion, with greatest multimorbidity evident in the consistently unsuppressed group.
Discussion: While older PLWH are more likely to achieve consistent HIV viral suppression, age-related multimorbidity was strongly associated with the failure to maintain viral suppression, resulting in higher medical costs for PLWH who were not virally suppressed. Health care providers treating older PLWH are advised to address multimorbidity in concert with other treatment strategies for helping these patients to achieve and maintain viral suppression.