Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective

Rapidly ageing HIV epidemic among men who have sex with men in Australia

John M. Murray A B C , Ann M. McDonald B and Matthew G. Law B

A School of Mathematics and Statistics, University of New South Wales, Sydney, NSW 2052, Australia.

B National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Level 2, 376 Victoria Street, Sydney, NSW 2010, Australia.

C Corresponding author. Email:

Sexual Health 6(1) 83-86
Submitted: 12 August 2008  Accepted: 15 January 2009   Published: 23 February 2009


Background: Antiretroviral therapy has increased survival for individuals living with HIV and has led to an ageing of this population in developed countries. To date the rate of ageing has been unquantified, giving rise to uncertainty in the treatment emphasis and burden in this population. Methods: A mathematical model was used in conjunction with HIV/AIDS data from the Australian National HIV/AIDS Registry to estimate numbers and ages of Australian men who have sex with men (MSM) living with HIV infection from 1980 to 2005. Results: The average age of HIV-infected Australian MSM is estimated to exceed 44 years of age by the year 2010 and has increased by 1 year of age for each two calendar years since the mid-1980s. HIV-infected MSM over 60 years of age have been increasing in number by 12% per year since 1995. A consequence of successful therapy with subsequent ageing of those infected has meant that from 2001 estimated deaths from other causes exceed AIDS deaths in Australia. Conclusions: In summary, our analyses indicate an increasing and rapidly ageing population living with HIV in Australia. This will inevitably lead to more serious non-AIDS conditions in ageing patients living with HIV, and to increased treatment complexity.

Additional keywords: HIV/AIDS, antiretroviral therapy, mortality.


[1]  Morgan D Mahe C Mayanja B Okongo JM Lubega R Whitworth JA 2002 HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries? AIDS 16 597 603 doi:10.1097/00002030-200203080-00011

[2]  Lohse N Hansen AB Pedersen G Kronborg G Gerstoft J Sorensen HT et al 2007 Survival of persons with and without HIV infection in Denmark, 1995–2005. Ann Intern Med 146 87 95

[3]  Van der Paal L Shafer LA Todd J Mayanja BN Whitworth JA Grosskurth H 2007 HIV-1 disease progression and mortality before the introduction of highly active antiretroviral therapy in rural Uganda. AIDS 21 Suppl 6 S21 9

[4]  UNAIDS, North America, Western and Central Europe: AIDS epidemic update regional summary. Geneva: UNAIDS; 2007 .

[5]  Shah S Mildvan D 2006 HIV and Aging. Curr Infect Dis Rep 8 241 7

[6]  Dolcini MM Catania JA Stall RD Pollack L 2003 The HIV epidemic among older men who have sex with men. J Acquir Immune Defic Syndr 33 Suppl 2 S115 21

[7]  Dougan S Payne LJ Brown AE Evans BG Gill ON 2004 Past it? HIV and older people in England, Wales and Northern Ireland. Epidemiol Infect 132 1151 60

[8]  Kohli R Klein RS Schoenbaum EE Anastos K Minkoff H Sacks HS 2006 Aging and HIV infection. J Urban Health 83 31 42 doi:10.1007/s11524-005-9005-6

[9]  National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2007. Sydney: The University of New South Wales; 2007.

[10]  Hoare A Wilson DP Regan DG Kaldor J Law MG 2008 Using mathematical modelling to help explain the differential increase in HIV incidence in New South Wales, Victoria and Queensland: importance of other sexually transmissible infections. Sex Health 5 169 87 doi:10.1071/SH07099

[11]  Jain SK . Trends in mortality: by causes of death in Australia, the states and territories during 1971–92, and in statistical divisions and sub-divisions during 1991–92. Canberra: Australian Bureau of Statistics; 1994.

[12]  Zar JH . Biostatistical analysis. 4th edn. New Jersey: Prentice-Hall; 1999.

[13]  National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS, Hepatitis C and Sexually Transmissible Infections in Australia Annual Surveillance Report 1999. Sydney: National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales; 1999.

[14]  Silverberg MJ Neuhaus J Bower M Gey D Hatzakis A Henry K et al 2007 Risk of cancers during interrupted antiretroviral therapy in the SMART study. AIDS 21 1957 63 doi:10.1097/QAD.0b013e3282ed6338

[15]  Carr A Grund B Neuhaus J El-Sadr WM Grandits G Gibert C et al 2008 Asymptomatic myocardial ischaemia in HIV-infected adults. AIDS 22 257 67

[16]  Petoumenos K Law MG 2006 Risk factors and causes of death in the Australian HIV Observational Database. Sex Health 3 103 12

[17]  Lewden C Salmon D Morlat P Bevilacqua S Jougla E Bonnet F et al 2005 Causes of death among human immunodeficiency virus (HIV)-infected adults in the era of potent antiretroviral therapy: emerging role of hepatitis and cancers, persistent role of AIDS. Int J Epidemiol 34 121 30 doi:10.1093/ije/dyh307

[18]  Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2005. Volume 17, Rev ed . Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2007.

[19]  Manfredi R Calza L Cocchi D Chiodo F 2003 Antiretroviral treatment and advanced age: epidemiologic, laboratory, and clinical features in the elderly. J Acquir Immune Defic Syndr 33 112 4

[20]  Hinkin CH Hardy DJ Mason KI Castellon SA Durvasula RS Lam MN et al 2004 Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS 18 Suppl 1 S19 25

[21]  Weber R Sabin CA Friis-Moller N Reiss P El-Sadr WM Kirk O et al 2006 Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study. Arch Intern Med 166 1632 41 doi:10.1001/archinte.166.15.1632

[22]  Monforte A Abrams D Pradier C Weber R Reiss P Bonnet F et al 2008 HIV-induced immunodeficiency and mortality from AIDS-defining and non-AIDS-defining malignancies. AIDS 22 2143 53 doi:10.1097/QAD.0b013e3283112b77

[23]  Friis-Moller N Reiss P Sabin CA Weber R Monforte A El-Sadr W et al 2007 Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med 356 1723 35 doi:10.1056/NEJMoa062744

[24]  Friis-Moller N Weber R Reiss P Thiebaut R Kirk O d’Arminio Monforte A et al 2003 Cardiovascular disease risk factors in HIV patients – association with antiretroviral therapy. Results from the DAD study. AIDS 17 1179 93 doi:10.1097/00002030-200305230-00010

Export Citation Cited By (22)