Yvette Alta Raphael radiates vitality and she isn’t old. But she grapples with brittle bones, aching knees and a vertigo so severe she’s had to stop driving for fear of causing an accident.
The 49-year-old entrepreneur is part of a generation of South Africans who have lived with HIV for decades and are now the first to grow old with the virus after revolutionary drugs turned a death sentence into a chronic ailment.
“My biggest fear now is living for many years with the compounded ailments of aging,” Raphael said in an interview. “The government doesn’t care. They are like, ‘We saved you to be a burden on us again?’” The longer government takes to address the needs of those aging prematurely with HIV, the bigger the financial drain in a country where 7.8 million people, or almost 13 percent of the population, live with the virus.
“It is becoming important that primary health-care clinics where HIV is also treated has the awareness that somebody who’s aging might have other health issues,” says Linda-Gail Bekker, chief executive officer of the Desmond Tutu Health Foundation in Cape Town. She also recommends monitoring people’s balance and handgrip strength, which can indicate early aging.
The Department of Health says the government is aware of the advantages of integrating non-HIV services into HIV programs but it would need more evidence regarding the cost-effectiveness of focusing on early senescence in people living with the virus. It’s also grappling with the growing burden of tuberculosis and non-communicable disease like cancer and diabetes.
At the moment, the country has no special services or programs for older people at the primary-care level, so they must compete with other patients for care.
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