Prevalence and incidence of HIV among people aged 50 years and older continue to rise worldwide, generating increasing awareness among care providers, scientists, and the HIV community about the importance of brain health in older adults with HIV. Many age-related factors that adversely affect brain health can occur earlier and more often among people with HIV, including epigenetic ageing, chronic medical conditions (eg, cardiovascular disease), and age-related syndromes (eg, frailty). Extensive dialogue between HIV community leaders, health-care providers, and scientists has led to the development of a multidimensional response strategy to protect and enhance brain health in people ageing with HIV that spans across public health, clinical spaces, and research spaces. This response strategy was informed by integrated ageing care frameworks and is centred on prevention, early detection, and management of brain health issues associated with HIV (eg, neurocognitive disorders), with specific considerations for low-resource or middle-resource countries. A collaborative, international, and data-informed update of the diagnostic criteria for HIV-associated neurocognitive disorders is a cornerstone of the proposed response strategy. The proposed response strategy includes a dynamic, international, online knowledge hub that will provide a crucial community resource for emerging evidence on the brain health of people ageing with HIV.

Quality of life (QoL) in people living with HIV (PLHIV) is reportedly worse than in people without HIV, with many factors impacting on this. We aimed to investigate QoL in PLHIV in New Zealand (NZ). In-person interviews were conducted including socio-demographic, health, social connectedness, and stigma-related questions. QoL was measured using the 13-question PozQoL Scale - summed to give a score between 13 and 65. Univariate linear regression was used to investigate factors associated with differences in PozQoL scores. PLHIV (n = 188) of different ethnicities from throughout NZ participated. The mean age was 47 years; 65% were men; 61% were men who have sex with men; 61% had been living with HIV for >= 10 years. The mean summary PozQoL score was 47.16. Factors associated with a lower mean PozQol included no sex in the last 12 months (-9.03), inability to meet basic needs (-7.47), ever (-6.49) or recently (-5.03), experiencing stigma or discrimination, mental health condition (-5.74), HIV diagnosis <5 years (-5.48), poor health (-5.43), being unemployed (-5.02), not having support (-4.71), and greater internalised stigma (-2.81). Improving QoL will require investment in peer support and community welfare programmes to better support PLHIV, and stigma reduction campaigns targeting the broader community.

AIM We describe the characteristics of women diagnosed with HIV and AIDS in Aotearoa New Zealand over the last 25 years, and of women living with HIV in New Zealand in order to guide the response for HIV prevention and care. METHODS Data on women diagnosed with HIV and AIDS in New Zealand (1996-2020) were collected through routine surveillance case reports from healthcare providers. CD4 cell count <350 cells/mm³ was considered a late diagnosis. Women living with HIV by 31 December 2020 included those first diagnosed in New Zealand and those previously diagnosed overseas. RESULTS A total of 634 women have been diagnosed with HIV (18% of all diagnoses in this time): most cases were acquired through heterosexual contact (82%). Twenty-eight percent (n=180/634) acquired HIV in New Zealand, of whom 43% were diagnosed late. AIDS was diagnosed in 128 women (72% within three months of HIV diagnosis). An estimated 570 women (77% aged >40 years) were living with diagnosed HIV at the end of 2020. CONCLUSION The number of women diagnosed with HIV each year in New Zealand has remained steady over recent years. More timely testing and diagnosis is essential to ensure women with HIV have access to appropriate treatment and support.