As you get older, it’s even more important to regularly attend clinic appointments and stay in touch with your healthcare providers.

Your HIV clinic appointments will include testing and screening for a wide range of health problems and conditions. This means that any warning signs can be spotted early.

It could give you the opportunity to take action to prevent problems getting worse. For example, you might be told that you need to make some changes to your eating habits. Or you may find that you need a medication, for example a statin to lower levels of cholesterol and prevent heart disease.

Guidelines from the British HIV Association say that all people living with HIV over the age of 50 should be having the following tests and reviews. Each should be done at least once a year, unless otherwise noted.

• Viral load
• Liver function
• Kidney function
• Cholesterol and triglycerides
• Risk assessment for cardiovascular disease
• Risk assessment for bone fractures (every three years)
• Blood test to check for diabetes
• Full blood count
• Hepatitis A, B and C (depending on your medical history)
• Sexually transmitted infections
• Review of all the medicines that you are taking.

Screening for certain cancers should also be done, but may be arranged through your GP. Women should have cervical screening every year, up to the age of 65. (This is more often than for people who don’t have HIV.) Women should have breast cancer screening every three years, between the ages of 50 and 70. Both men and women need bowel cancer screening every two years, between the ages of 50 and 74.

Transgender men who have a cervix or breast tissue should talk to their GP to ensure that they are invited for these screening programmes, in the same age bands as cisgender women.

There’s more information about these health conditions below.

Lipids are fatty substances that are found in the blood and which the body needs. However, high levels of the lipids called LDL cholesterol and triglycerides are harmful. They can result in a narrowing and hardening of the arteries over time, making it harder for blood and the oxygen it carries to reach the heart and other organs.

How is it treated? Many people can bring LDL cholesterol and triglycerides down to a healthy level with lifestyle changes such as diet and exercise. If not, drugs known as statins and fibrates are very effective. Some statins interact with some anti-HIV drugs, so a doctor prescribing a statin for you must know about your HIV treatment.

Are things any different for people living with HIV? Raised lipids are one of the most common health problems in people living with HIV, especially as they get older. This is probably due to a combination of lifestyle factors (like smoking and not being physically active) and the response of the immune system to HIV infection. While taking HIV treatment is generally beneficial for your heart, some protease inhibitors can affect lipid levels. If this occurs, you may need to switch to other anti-HIV drugs.

How can you lower the risk? Eat a healthy, balanced diet with plenty of fruit, vegetables and other high-fibre foods, while avoiding saturated fat. Lose weight if you are overweight, get some physical activity every day, limit your alcohol intake, and don’t smoke.

What’s the link with other conditions? High levels of lipids increase your risk of heart attack, stroke, angina (chest pains), heart failure and other forms of cardiovascular disease.

Blood pressure is the pressure of blood in your arteries – the vessels that carry blood from your heart to your brain and the rest of your body. If blood pressure is too high (also called hypertension), it causes a strain on the walls of your arteries and on your heart.

How is it treated? Some people are able to lower their blood pressure with lifestyle changes, such as diet, exercise and stopping smoking. If not, your doctor may prescribe daily tablets. When choosing this medication, your doctor should check for drug interactions with your HIV treatment.

Are things any different for people living with HIV? Many people living with HIV have high blood pressure, generally for similar reasons to people in the general population (for example, people who are overweight or have diabetes are at increased risk). Older anti-HIV drugs that caused changes in fat distribution may also be a factor.

How can you lower the risk? The advice is very similar to that for lowering lipids. Eat a healthy, balanced diet with plenty of fruit, vegetables and other high-fibre foods, while avoiding salt and saturated fat. Get some physical activity every day, lose weight if you are overweight, and drink less alcohol.

What’s the link with other conditions? Having high blood pressure greatly increases your risk of having a heart attack or stroke. High blood pressure can make kidney disease worse. Also, people who have diabetes or kidney disease are at greater risk of having high blood pressure.

Type 2 diabetes is a disease where the amount of glucose (sugar) in the blood is too high because the body cannot process it properly. A blood test can show whether your blood glucose level is normal, higher than normal, or at a level which means you have diabetes.

How is it treated? The first step is to make changes to the food you eat and to be more physically active, in order to reduce body weight and control your blood sugars. If this doesn’t bring diabetes under control, drugs may be used as well.

Are things any different for people living with HIV? Rates of diabetes are a little higher in people living with HIV than in the general population. This seems to be partly due to many HIV-positive people having risk factors for diabetes (like being overweight). It’s also due to the impact of HIV on the body and the previous use of some older anti-HIV drugs.

How can you lower the risk? Lose weight, especially if you have excess weight around your belly; do more exercise (especially aerobic exercise); and eat a healthy, balanced diet with plenty of fruit, vegetables and other high-fibre foods.

What’s the link with other conditions? High cholesterol and high blood pressure are associated with an increased risk of diabetes. Having diabetes raises the risk of heart disease, kidney disease, peripheral neuropathy, erection difficulties and problems with your eyesight.

The kidneys are organs that filter blood and help maintain the optimal balance of salts and minerals in the body. When the kidneys fail, excess fluid and waste products build up in the body. This can lead to you feeling unwell, gaining weight, being breathless and having swollen hands and feet.

How is it treated? If diabetes or high blood pressure is the underlying cause of kidney disease, managing this condition is vital. This may involve lifestyle changes and medications.

Are things any different for people living with HIV? HIV may contribute to kidney disease. Overall, HIV treatment protects the kidneys, but some anti-HIV drugs can contribute to kidney problems in a minority of people, so you might need to change your anti-HIV drugs if you have kidney disease.

How can you lower the risk? Lose weight if you’re overweight; exercise regularly; don’t smoke; eat a healthy, balanced diet; and limit your intake of drugs and alcohol.

What’s the link with other conditions? The two most important causes of kidney disease are high blood pressure and diabetes. Having heart disease, hepatitis B or hepatitis C also make kidney problems more likely. Kidney disease raises the risk of heart problems.

Hepatitis C is a viral infection which can damage the liver, an essential body organ. The liver’s ability to renew and repair itself declines with age.

How is it treated? Modern drug treatment typically lasts for two or three months, usually does not cause side-effects and cures more than 95% of people. Curing hepatitis C stops the progression of liver disease in most people.

Are things any different for people living with HIV? Because HIV and hepatitis C are transmitted in similar ways, a number of people living with HIV also have hepatitis C. HIV-positive people with hepatitis C tend to have faster liver disease progression but treatment is just as effective as it is for other people. Taking HIV treatment helps reduce the risk of liver disease progression.

How can you lower the risk? To avoid infection, don’t share needles or other equipment to inject drugs. Gay and bisexual men can also avoid sexual transmission by using condoms during anal sex and wearing gloves during fisting.

What’s the link with other conditions? If left untreated, hepatitis C can cause serious liver damage, including fibrosis, cirrhosis and liver cancer. Although people with hepatitis C are at greater risk of joint and skin problems, heart disease, strokes and diabetes, curing hepatitis C should reduce the risk of these conditions.

There are more than 200 different types of cancer; in each one some of the body’s cells begin to divide without stopping and spread into surrounding tissues. While some cancers cause solid lumps that grow in size, other cancers start in the blood or the immune system.

How is it treated? Different types of cancers are treated in different ways. Most people have a combination of treatments, for example chemotherapy and surgery, or chemotherapy and radiotherapy. For some cancers, newer types of drug treatment with fewer side-effects are available.

Are things any different for people living with HIV? Rates of some (but not all) cancers are higher in people with HIV than other people, because damage to the immune system appears to disrupt the ability of the body to keep infections under control and stop cancers from growing. Taking effective HIV treatment significantly lowers your risk of developing these cancers.

How can you lower the risk? Changes to your lifestyle can reduce your risk of developing cancer – a quarter of cancers in people living with HIV are linked to smoking. It’s also advisable to limit your intake of alcohol, eat a healthy diet, lose weight if you’re overweight, exercise regularly, and protect your skin from the sun.

What’s the link with other conditions? Some viral infections can result in cancers, including human papillomavirus (cervical cancer and anal cancer) and hepatitis B and C (liver cancer). Having diabetes raises the risk of some types of cancer.

Depression is an ongoing low mood which interferes with your everyday life. Symptoms range from lasting feelings of unhappiness and hopelessness, and losing interest in the things you used to enjoy, to feeling very tearful or even suicidal. In older people especially, the symptoms may be physical, such as feeling constantly tired, sleeping badly or having no sex drive.

How is it treated? Depression is a recognised illness and is treatable. Talking therapies involve talking to a professional about your thoughts and feelings. Anti-depressant medications relieve the symptoms of depression by adjusting chemicals in the brain. It’s usually best to combine both approaches.

Are things any different for people living with HIV? People who have serious medical conditions, people who have faced stressful and traumatic events and people who have had financial difficulties are more likely to experience depression. This may partly explain why it’s a common condition in people living with HIV. The anti-HIV drug efavirenz is not recommended for people who’ve had depression.

How can you lower the risk? There are things you can do to look after your emotional health – talk about your experiences and feelings with other people; connect with others; take part in activities you find engaging and rewarding; stay physically active; and limit your intake of alcohol and drugs.

What’s the link with other conditions? Depression may make it harder to manage other medical conditions, for example to make lifestyle changes or to take all the doses of your medication.

While some decline in memory and thinking skills is a normal part of getting older, more significant changes are called ‘cognitive impairment’. The most common causes of cognitive problems in HIV-positive people are not related to HIV, but to alcohol and drug use; depression and other mental health problems; or Alzheimer’s disease, stroke, a narrowing of the small blood vessels in the brain and other conditions that reduce blood flow to the brain.

How is it treated? Treatment generally focuses on dealing with the lifestyle factors or medical problems that appear to be contributing to cognitive impairment. You can also get help with managing the impact of cognitive impairment in your day-to-day life.

Are things any different for people living with HIV? One form of cognitive impairment occurs when HIV (or the response of the immune system to HIV) directly affects the brain and causes cognitive problems. HIV treatment helps to prevent this condition, which is now rare.

How can you lower the risk? The same things which will protect the health of your heart will also help protect your memory and thinking skills. Eat a healthy, balanced diet; exercise regularly; don’t smoke; and lose weight if you are overweight. You should also limit your intake of alcohol and recreational drugs, and keep your brain active by continuing to be socially connected.

What’s the link with other conditions? Your physical health has a great impact on cognitive processes. Having raised cholesterol, diabetes, high blood pressure, hardening of the arteries, stroke, mini-stroke or depression increases the risk of cognitive impairment.

If you have low bone mineral density, this means that some of your bones have lost some of their strength and that you are at greater risk of a broken bone (fracture) after a minor trip or fall.

How is it treated? Lifestyle changes (exercise and diet) can help prevent the problem getting worse. You may be advised to take calcium and vitamin D supplements. Some people are prescribed bisphosphonate medications.

Are things any different for people living with HIV? Bone problems are a little more common in people living with HIV than in the general population. This is probably due to a combination of lifestyle factors (like not getting enough exercise) and the response of the immune system to HIV infection.

Also, some anti-HIV drugs can have an impact on the bones. Changing your HIV treatment is usually only recommended if you have been diagnosed with low bone mineral density (osteoporosis) or have other risk factors for bone problems. Check with your doctor before taking calcium supplements as they interact with some anti-HIV drugs.

How can you lower the risk? Get some weight-bearing exercise regularly (for example, walking, running, jumping, dancing and weightlifting); do exercises that help with balance and reduce the risk of falls; don’t smoke; drink less alcohol; include foods rich in calcium in your diet (like dairy products and dark green leafy vegetables); and get some sunlight on your skin (for vitamin D production).

What’s the link with other conditions? Low bone mineral density is especially common for women who have gone through the menopause.

‘Frailty’ is a term doctors use to describe a general decline in physical health and a loss of reserves. This leads to a person being less robust and less able to bounce back after an adverse event. A person with frailty may move more slowly, have lost some of their physical strength, have less energy and be less mentally agile. Frailty tends to get worse after each period of poor health or mental stress.

How is it treated? A comprehensive, holistic assessment by a healthcare professional can often identify changes that could help reduce frailty. These could include exercises to help you be more mobile, help to make other lifestyle changes, providing nutritional supplements, and changes to medication (sometimes, drug interactions can cause problems).

Are things any different for people living with HIV? Frailty may be more common in people living with HIV than in HIV-negative people of the same age, perhaps because of the number of other health conditions that HIV-positive people have.

How can you lower the risk? Keep physically active, which will help you maintain your muscle strength, keep your balance and remain as independent as possible. Make sure you have a balanced diet, with a wide range of nutrients. Stay socially connected with people you know and look after your mental health.

What’s the link with other conditions? Most people with frailty already have several health problems. Those with frailty are more vulnerable than other people to an adverse event like an infection or falling over – they may have more difficulty recovering from it.

The menopause usually happens to women between the ages of 45 and 55. As a result of a change in the balance of the body’s sex hormones, periods become less frequent or irregular for a few months or years, before they stop altogether. This may be accompanied by symptoms such as hot flushes, night sweats, joint and muscle pain, vaginal dryness, mood changes and a lack of interest in sex.

How is it managed? The menopause is a natural part of the ageing process. But if the symptoms of menopause are interfering with your daily life, then hormone replacement therapy (HRT) can help relieve symptoms and improve quality of life. HRT works by replacing hormones that naturally fall in menopause.

Are things any different for people living with HIV? Some studies suggest that women living with HIV may experience the menopause a little earlier and have more severe symptoms than other women.

What’s the link with other conditions? Women lose about 10% of their bone mass during the menopause process, increasing the risk of bone problems and bone fractures. After the menopause women may be more vulnerable to heart disease and stroke. For these reasons, being active and mobile in later life is important.

• CD4, viral load & other tests Information booklet
• HIV, mental health & emotional wellbeing Information booklet

Simple factsheets:

• Cholesterol
• High blood pressure
• Type 2 diabetes
• Chronic kidney disease
• Hepatitis C
• Cancer
• Anal cancer
• Cognitive impairment
• Bone problems
• Menopause