{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T06:09:16Z","timestamp":1778479756608,"version":"3.51.4"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With the widespread implementation of antiretroviral therapy (ART), human immunodeficiency virus\/acquired immunodeficiency syndrome (HIV\/AIDS) has gradually transitioned from a highly fatal infectious disease to a manageable chronic condition. Simultaneously, global population aging has accelerated, making older adults with HIV (\u226575\u202fyears) an increasingly important group in terms of disease burden. However, the epidemiological characteristics, disease spectrum, and long-term trends of this population\u2014including key metrics such as incidence, mortality, prevalence, and disability-adjusted life years (DALYs)\u2014remain inadequately assessed, particularly regarding epidemiological transitions and inter-country differences in this age group across G7 nations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data on HIV\/AIDS and its subtypes from 1990 to 2021 were obtained from the Global Burden of Disease (GBD) 2021 database for G7 countries (Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States) among individuals aged \u226575\u202fyears. Metrics included age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized prevalence rate (ASPR), and DALYs. Stratified analyses were performed by age groups (75\u201379, 80\u201384, 85\u201389, 90\u201394, \u226595\u202fyears), sex, and disease subtype. Long-term trends were assessed using Joinpoint regression, calculating the annual percent change (APC) and average annual percent change (AAPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 1990 and 2021, the incidence and mortality of HIV\/AIDS in older adults declined continuously in most G7 countries, reflecting the effectiveness of ART and public health interventions. In contrast, prevalence and DALYs increased in some countries, indicating an asymmetric pattern of \u201cdecreasing incidence and mortality, but increasing survival and disability.\u201d Considerable heterogeneity existed among countries: the United States and several European countries exhibited a high burden among surviving individuals, whereas Japan showed a consistently increasing trend. Sex-specific analysis revealed a higher overall burden in males than females, although the sex gap narrowed in the oldest age groups. The disease spectrum shifted over time, with a declining burden of drug-susceptible tuberculosis and non-communicable chronic diseases (conditions associated with HIV\/AIDS) emerging as the primary drivers of DALYs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Older adults should be incorporated into HIV prevention, screening, and health management strategies, with particular attention to chronic disease management, functional maintenance, and multidisciplinary care to address the long-term health challenges posed by aging HIV cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1811915","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T05:28:58Z","timestamp":1778477338000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term evolution of the burden of HIV\/AIDS in older adults: a global burden of disease analysis in individuals aged \u226575\u202fyears in G7 countries"],"prefix":"10.3389","volume":"14","author":[{"given":"Ruizhuang","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Ruijin-Hainan Hospital, Shanghai Jiaotong University School of Medicine (Hainan Boao Research Hospital)","place":["Qionghai, Hainan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Shenyang Medical College","place":["Shenyang, Liaoning, China"]},{"name":"Department of Nursing, Ruijin Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]},{"name":"Department of Nursing, Ruijin-Hainan Hospital, Shanghai Jiaotong University School of Medicine (Hainan Boao Research Hospital)","place":["Qionghai, Hainan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingyu","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Boao International Hospital of Shanghai University of Traditional Chinese Medicine","place":["Qionghai, Hainan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingxia","family":"Zhou","sequence":"additional","affiliation":[{"name":"Hainan Vocational University of Science and Technology","place":["Haikou, Hainan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chonghui","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Ruijin-Hainan Hospital, Shanghai Jiaotong University School of Medicine (Hainan Boao Research Hospital)","place":["Qionghai, Hainan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingting","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ruijin-Hainan Hospital, Shanghai Jiaotong University School of Medicine (Hainan Boao Research Hospital)","place":["Qionghai, Hainan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Long","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ruijin-Hainan Hospital, Shanghai Jiaotong University School of Medicine (Hainan Boao Research Hospital)","place":["Qionghai, Hainan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ruijin-Hainan Hospital, Shanghai Jiaotong University School of Medicine (Hainan Boao Research Hospital)","place":["Qionghai, Hainan, China"]},{"name":"Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.tips.2021.10.004","article-title":"Update and latest advances in antiretroviral therapy","volume":"43","author":"Menendez-Arias","year":"2022","journal-title":"Trends Pharmacol Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/j.idc.2024.04.005","article-title":"Weight gain and antiretroviral therapy","volume":"38","author":"Bailin","year":"2024","journal-title":"Infect Dis Clin N Am"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41586-018-0457-8","article-title":"Facing up to the global challenges of ageing","volume":"561","author":"Partridge","year":"2018","journal-title":"Nature"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"5695","DOI":"10.1002\/alz.13844","article-title":"Sex and gender differences in cognitive resilience to aging and Alzheimer's disease","volume":"20","author":"Arenaza-Urquijo","year":"2024","journal-title":"Alzheimers Dement"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3010","DOI":"10.1097\/CM9.0000000000003410","article-title":"Immune aging and infectious diseases","volume":"137","author":"Chen","year":"2024","journal-title":"Chin Med J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12879-020-05749-2","article-title":"HIV infection and multidrug resistant tuberculosis: a systematic review and meta-analysis","volume":"21","author":"Sultana","year":"2021","journal-title":"BMC Infect Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1928","DOI":"10.1186\/s12889-025-23121-4","article-title":"Global and regional disease burden of HIV\/AIDS from 1990 to 2021 and projections to 2030","volume":"25","author":"Lu","year":"2025","journal-title":"BMC Public Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/s40249-024-01230-3","article-title":"Epidemiological features and temporal trends of the co-infection between HIV and tuberculosis, 1990-2021: findings from the Global Burden of Disease Study 2021","volume":"13","author":"Zhang","year":"2024","journal-title":"Infect Dis Poverty"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1016\/S2352-4642(22)00219-X.20220913","article-title":"Global, regional, and national burdens of HIV and other sexually transmitted infections in adolescents and young adults aged 10-24 years from 1990 to 2019: a trend analysis based on the Global Burden of Disease Study 2019","volume":"6","author":"Zhang","year":"2022","journal-title":"Lancet Child Adolesc Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1016\/S1474-4422(18)30295-3","article-title":"Global, regional, and national burden of Parkinson's disease, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"17","year":"2018","journal-title":"Lancet Neurol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1007\/s11904-021-00547-0","article-title":"Probing the interface of HIV and inflammaging","volume":"18","author":"Sieg","year":"2021","journal-title":"Curr HIV AIDS Rep"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1244622","DOI":"10.3389\/fimmu.2023.1244622","article-title":"The kynurenine pathway in HIV, frailty and inflammaging","volume":"14","author":"Sultana","year":"2023","journal-title":"Front Immunol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s12916-025-04545-6","article-title":"HIV infection and immunosenescence: challenges and intervention strategies","volume":"24","author":"Jin","year":"2025","journal-title":"BMC Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e70320","DOI":"10.1111\/acel.70320","article-title":"Extracellular vesicles favor early peripheral immunosenescence through modulation of the senescence-associated secretory phenotype in HIV infection","volume":"25","author":"Castro","year":"2026","journal-title":"Aging Cell"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1016\/j.idm.2025.06.001","article-title":"Estimating undiagnosed HIV infections by age group in Japan: an extended age-dependent back-calculation","volume":"10","author":"Fujiwara","year":"2025","journal-title":"Infect Dis Model"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"101860","DOI":"10.1016\/j.eclinm.2023.101860","article-title":"Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis","volume":"57","author":"Chowdhury","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e70727","DOI":"10.1002\/hsr2.70727","article-title":"Addressing cardiometabolic challenges in HIV: insights, impact, and best practices for optimal management-a narrative review","volume":"8","author":"Mugisha","year":"2025","journal-title":"Health Sci Rep"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.psychres.2014.04.015","article-title":"The concomitant use of second-generation antipsychotics and long-term antiretroviral therapy may be associated with increased cardiovascular risk","volume":"218","author":"Ferrara","year":"2014","journal-title":"Psychiatry Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2326","DOI":"10.1001\/jama.2019.6587","article-title":"Screening for HIV infection: US preventive services task force recommendation statement","volume":"321","author":"Owens","year":"2019","journal-title":"JAMA"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e269","DOI":"10.1016\/S2352-3018(22)00003-0","article-title":"Delayed presentation of HIV among older individuals: a growing problem","volume":"9","author":"Justice","year":"2022","journal-title":"Lancet HIV"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1811915\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T05:28:59Z","timestamp":1778477339000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1811915\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,11]]},"references-count":20,"alternative-id":["10.3389\/fpubh.2026.1811915"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1811915","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,11]]},"article-number":"1811915"}}