Dr. James Schmidtberger of Gouverneur, co-author of "Aging with HIV: A Gay Man's Guide."

Dr. James Schmidtberger, an attending physician at Gouverneur Healthcare Services, says he has patients who were not expecting to still be his patients in the year 2010. “There are plenty of patients who I knew when they were 40 and they didn't think they were going to live to be 50. And now they're in their 50s and 60s.”

That's because Dr. Schmidtberger's patients are HIV positive and, thanks to anti-retroviral drugs, are living longer and belong to a growing population of people over 50 with HIV.

At the same time, infections have continued over the last three decades and some people are being diagnosed with HIV in their 40s and 50s, adding more people to the aging-with-HIV population, Dr. Schmidtberger said. He is one of the authors of “Aging with HIV: A Gay Man's Guide,” published this month by Oxford University Press.

More than 107,000 New York City residents are living with HIV or AIDS, and more than 35,000 of them, or about 33 percent, are over the age of 50. At HHC, 32.5 percent of the 17,931 HIV patients were over 50 in Fiscal Year 2009, the most recent year for which data is available.

HHC has been in the forefront of offering HIV testing and continues to expand testing by making it a routine part of patients' healthcare. HHC has offered HIV rapid testing since 2006, and has helped more than 666,162 New Yorkers learn their HIV status.

“Our HIV Testing Expansion Initiative is the largest routine HIV testing program in the United States within a single healthcare system. By making testing available in as many settings as possible, we are increasing the numbers of early detections­, one of the most important aspects of fighting this devastating illness,” said HHC President Alan D. Aviles.

More than 90 % of patients diagnosed positive at HHC facilities are linked to life-saving HIV medical care and treatment within 90 days of being diagnosed.

As of September 1st, a new state law requires that healthcare providers offer patients a voluntary HIV test, with limited exceptions.

Dr. Schmidtberger said that treating HIV patients as they age calls for a big emphasis on primary care and making sure you are meeting the needs of an older adult as well as an HIV patient.

“You've got to look out for other chronic diseases such as heart disease, cholesterol, diabetes, kidney disease and bone disease. You've got to talk about the importance of diet and exercise and smoking cessation. Then you've got to add onto that the fact that you are dealing with someone who's HIV positive,” he said. The doctor must consider whether the patient's HIV status is playing a role in another illness and, when prescribing medicines, take into account the interaction with the anti-retroviral drugs.

“We can't forget that it's not just the HIV we're treating. We've got to treat the whole person,” he said.

HHC's 11 acute care hospitals are Designated AIDS Centers. All HHC hospitals, diagnostic and treatment centers, and clinics offer specialized HIV care to all New Yorkers, regardless of ability to pay or immigration status. To find a public hospital or health center providing HIV testing and treatment in New York City, visit nyc.gov/hhc or call 311.

December 2010