Sleep disruption and its psychological treatment in young people at risk of psychosis: A peer methods qualitative evaluation.

Advancements in HIV care, particularly the wide-spread use of antiretroviral therapy (ART), have transformed HIV from a fatal illness into a chronic condition. People living with HIV who receive early diagnosis and consistent treatment now often achieve lifespans comparable to those without the virus []. Thus, recent years in high-income countries have seen a shift in demographics, with roughly half of individuals living with HIV in the United States, the United Kingdom, and Europe now 50 years of age and older []. Comprehensive care models addressing aging-related comorbidities and mental health further enhance quality of life, ensuring long-term health and well being []. This article describes the emerging clinical interventions that hold promise to better integrate geriatric care and HIV treatment. People aging with HIV face unique care considerations and challenges in receiving comprehensive care []. Initial HIV infection has been associated with epigenetic aging, such as genomic methylation changes and telomere shortening, compared to uninfected individuals with the same chronological age []. When poorly controlled, the chronic, low-grade inflammation associated with immune response to the HIV virus may further accelerate aging []. Even with viral suppression, persistent systemic inflammation and immune activation contribute to the accelerated onset of age-related conditions []. ART toxicities further exacerbate these risks, increasing the likelihood of multimorbidity and polypharmacy, while disparities in treatment access may deepen inequities in care. Frailty and geriatric syndromes are major concerns, as people with HIV often experience aging-related conditions earlier than their HIV-negative peers []. This population faces higher rates of falls, cognitive decline, and functional impairment, concurrent with higher rates of depression, necessitating earlier and more aggressive interventions []. Addressing these challenges requires a shift toward holistic, patient-centered care that integrates HIV treatment with chronic disease management, mental health services, and social support systems for loneliness and isolation to ensure sustained health and quality of life as they age []. New approaches can take the form of adapting general geriatric frameworks, such as the ‘Matters, Medication, Mentation, Mobility, and Multimorbidity’ Framework, more commonly known by its mnemonic ‘5Ms’ []. The 5Ms hold promise for cognitive health, physical function, and individualized goals, especially for women []. Ensuring long-term health outcomes will depend on evolving care frameworks that prioritize early intervention, coordinated care, and equitable access to comprehensive healthcare services.