Perceptions of Aging from Persons Living and Aging with HIV: A Qualitative Study

Background/Objectives: People aging with HIV (PAWHs) face distinct health challenges, including early onset of aging and heightened risk for chronic comorbidities despite effective antiretroviral therapy (ART). However, significant gaps persist in understanding the lived experience and how PAWHs perceive the interplay between their controlled HIV and the aging process. This study examined PAWHs’ illness perceptions of aging, health, and relationship of HIV to other health conditions. Methods: Semi-structured interviews were conducted with a convenience sample of 25 PAWHs (mean age 63.5; mean time living with HIV 22.3 years; 24 virally suppressed) recruited through an academic HIV specialty clinic. Demographic and clinical data were collected from Electronic Health Records (EHRs), and interviews were analyzed using inductive thematic analysis. Results: A central finding was the disconnect between participants’ illness perceptions of controlled HIV and other aging-related health concerns. Absence of acute somatic symptoms and sustained viral suppression fostered a view of HIV as chronologically remote, leading to an apparent unawareness of HIV’s systemic links to accelerated aging and comorbidities. Two primary themes around aging emerged: acceptance/disengagement and fear of future debility (prevalent among older, socially isolated individuals concerned about dementia and finances). Conclusions: This pervasive disconnect, understandable through the lens of the Common Sense Model of Self-Regulation, highlights a critical need to adjust health counseling strategies for PAWHs. Clinicians can leverage existing trusted provider relationships to explicitly address and refine PAWHs’ illness models, clarifying that viral suppression is not a cure and educating on HIV’s systemic links to chronic conditions (e.g., ‘inflammaging’). Tailored educational interventions are crucial for fostering shared decision-making, encouraging early screening, and improving health outcomes for this vulnerable and growing population. Generalizability may be limited by sample characteristics.