Nowadays, people with HIV can live long and healthy lives. This can be attributed to major improvements in HIV treatments and awareness.

Currently, nearly half of people living with HIV in the United States are ages 50 or older.

But as you get older, living with HIV can present additional challenges. It’s important to take extra precautions to maintain both physical and mental health, even if HIV medications are working.

Here are five things to know about HIV as you age.

People living with HIV may still deal with the chronic conditions and physical changes that come with aging. Research shows that people with HIV also have a higher risk for chronic non-HIV diseases compared with those without HIV.

Despite enormous improvements in treatment, living with HIV over time can cause stress on the body. Once HIV enters the body, it directly attacks the immune system.

The immune system is then constantly active as it tries to fight off the virus. Years of this can produce chronic, low-level inflammation throughout the body.

Long-term inflammation is associated with many age-related conditions, including:

  • heart disease, including heart attack and stroke
  • liver disease
  • certain cancers, including Hodgkin’s lymphoma and lung cancer
  • type 2 diabetes
  • kidney failure
  • osteoporosis
  • neurological diseases

HIV and its treatments can also affect the brain’s function over time. Studies show that older people with HIV have an increased risk for developing cognitive impairments, including deficits in:

  • attention
  • executive function
  • memory
  • sensory perception
  • information processing
  • language
  • motor skills

Researchers estimate that between 30 and 50 percent of people with HIV will experience some form of neurocognitive decline. The decline may be mild to severe.

Older people with HIV may take several medications. These can be for treating HIV and comorbid conditions, like diabetes, high blood pressure, osteoporosis, and heart disease.

This puts older people with HIV at risk for polypharmacy. This is the medical term for the use of more than five different types of drugs at a time. People taking several medications may have a higher risk for:

  • falls
  • interactions between drugs
  • side effects
  • hospitalizations
  • drug toxicities

It’s important that you take your medications as prescribed and on schedule. Always inform your doctor of all the medications you’re taking.

The stigma of HIV can lead to emotional problems, including depression. Older people with HIV may have a sense of lost community and social support. Experiencing issues with cognition can also lead to depression and emotional distress.

As you get older, it’s essential that you find ways to maintain your emotional health. Stay connected with loved ones, engage yourself in a fulfilling hobby, or consider joining a support group.

Women usually go through menopause between the ages of 45 and 55, with an average age of 51. More research is needed, but women living with HIV may experience menopause earlier.

Some evidence also suggests that menopause symptoms may be more severe for women living with HIV, but research is limited. This may be related to the immune system’s response to HIV or the production of hormones that affect menopause.

Common menopause symptoms include:

  • hot flashes, night sweats, and flushing
  • insomnia
  • vaginal dryness
  • weight gain
  • depression
  • memory problems
  • reduced sex drive
  • hair thinning or loss

Menopause can also accelerate the onset of many age-related diseases. This includes:

  • heart disease
  • high blood pressure
  • diabetes
  • reduced bone mineral density

People with HIV who are ages 50 or older need to get regular checkups with their primary care doctor. These regular checkups should include monitoring of your:

  • cholesterol levels
  • blood sugar
  • blood pressure
  • blood cell counts
  • bone health

On top of this, it’s important to foster heart-healthy habits, like:

  • getting regular exercise
  • quitting smoking
  • eating a healthy diet rich in fruits, vegetables, lean proteins, and whole grains
  • reducing stress
  • reducing alcohol intake
  • managing your weight
  • adhering to your treatment plan

Your doctor may prescribe medications to prevent bone loss or recommend vitamin D and calcium supplements. They may also prescribe medications to treat high blood pressure, diabetes, or heart disease.

Your doctor may recommend you visit a mental health professional. Psychiatrists, psychologists, and therapists are all professionals who can help you work through your emotions and offer you support.

The outlook for people living with HIV has improved considerably over the past 20 years. But increased rates of comorbidities and cognitive changes can pose challenges as you age.

While the added health challenges of aging with HIV may seem daunting, don’t be discouraged. There are plenty of ways that you can help minimize your risk.

See your doctor for regular checkups for common health conditions related to aging, and adhere to your HIV medications.