Season 3 Episode 3: Aging with HIV: Why Long-Term Care Matters

Andie Morataya

Hey everyone! Thanks for listening in to our latest episode of the Better Living Through Data podcast! Anthony, tomorrow September 18th is National HIV/AIDS and Aging Awareness Day, and honestly, when I was looking at the recent numbers, one specific stat completely re-framed everything for me.

Anthony Pero

Which stat are you looking at, Andie?

Andie Morataya

The CDC baseline data. More than half of people living with diagnosed HIV in the United States and dependent areas are aged 50 and older. More than half.

Anthony Pero

Fifty and older, yeah. That, that fifty percent threshold is massive because historically, people thought of HIV management as, well, purely about virological control, right? Getting the viral load down to undetectable.

Andie Morataya

Right, right, exactly!

Anthony Pero

But when over half the population is over 50, the clinical reality in long term care totally shifts. You are no longer just managing antiretroviral therapy, or ART. You are balancing ART against multi organ comorbidities, like cardiovascular disease and metabolic disorders.

Andie Morataya

And that is where the friction happens, right? Because growing up seeing headlines in the nineties or early two thousands, public perception got, like, stuck in this idea that suppressing the virus was the end of the story. But in a geriatric care environment, a clinician orders an ART regimen and then has to figure out how it interacts with three different blood pressure meds and a diabetes regimen!

Anthony Pero

Polypharmacy, yeah. Polypharmacy in an aging survivor is wildly complex. If a resident has hypertension and metabolic syndrome on top of long term HIV, every single drug interaction carries risk. You cannot evaluate the HIV therapy in a vacuum anymore.

Andie Morataya

Which brings us right back to why the real world evidence from electronic health records is so critical here. When we look at PointClickCare's HIV dataset, we are talking about over 90,000 unique patient records with HIV, and over 6,400 active records in long term care settings right now.

Anthony Pero

Six thousand four hundred active long term care residents. And remember, in post acute and long term care, the average length of stay for these residents is over 800 days.

Andie Morataya

800 days! That is over two full years of continuous daily observation.

Anthony Pero

Yes, and on average, the EHR captures over 50 clinical data points per patient per day. So over an 800 day stay, you are not just seeing a snapshot lab result every six months like you might in an outpatient clinic. You are tracking longitudinal trends.

Andie Morataya

Wait, so give me a concrete example of how those 50 points a day actually help a care team on the floor.

Anthony Pero

Okay, take immunological markers like CD4+ T cell counts or inflammatory cytokines like IL 2 and IL 6. You track those alongside routine daily vitals, things like blood sugar, blood pressure, and oxygen saturation. If oxygen sat or daily glucose starts drifting while cytokine levels show systemic inflammation, you catch physiological decline weeks before an acute event happens.

Andie Morataya

Oh, wow. So you see the physiological drift in real time instead of waiting for a crisis hospital transfer.

Anthony Pero

Exactly. And it extends to cognitive tracking too. We know cognitive changes can happen with long term HIV, but clinicians often struggle to differentiate HIV associated neurocognitive disorders from classic age related dementia or Alzheimer's.

Andie Morataya

Right, because how do you tell them apart without deep baseline tracking?

Anthony Pero

Well, that is where standardized scores like the Brief Interview for Mental Status, or BIMS, come in. By tracking BIMS scores longitudinally across that 800 day residency, researchers and payers can see whether a cognitive decline is sudden or gradual, and match it against medication changes or systemic inflammatory spikes.

Andie Morataya

That level of granularity across 90,000 records is incredible. It really allows life science partners and commercial or Medicare plans to build actual personalized protocols for aging survivors rather than relying on broad guesswork.

Anthony Pero

It really does. And as this population continues to age, the big question for health systems and life science research is, how quickly can we adapt care pathways when long term care becomes the main frontline for HIV management?

Andie Morataya

That is the question that needs an answer, Anthony! We’d love to hear our listeners’ perspectives!

Anthony Pero

Hey Andie, that’s a great call out! We’d love to hear from all of you on this topic! In the meantime, If you would like to learn more about our data, and dig into our HIV dataset, visit the link in today’s podcast description!

Andie Morataya

See you next week, everyone!