Aging and HIV infection: Case studies detailing one family's multigenerational experience with HIV infection

Case studies were developed for three generations of women, all of whom were diagnosed with HIV infection, and received some form of antiretroviral (ARV) treatment. Laboratory findings associated with HIV therapy in the daughter and granddaughter included CD4 counts of greater than 500 cells/mm³ and undetectable viral loads. However, while the grandmother’s CD4 count was consistently in 400 cells/mm³ to 500 cells/mm3 range, her viral load was detectable, and she choose to remain on monotherapy, despite the treatment successes experienced by her daughter and granddaughter. Comorbid conditions and treatment side effects were presented, as these were related to grandmother’s decision to remain on monotherapy. In spite of what many clinicians might determine to be a less than satisfactory treatment outcome, the grandmother has been described as a long term survivor of HIV infection, and the experiences and support system shared by these women have contributed to their excellent health status, even in the presence of HIV infection. Since the women received their health care from the same physician based at an urban university-based hospital, factors related to continuity of care and a holistic care focus were also examined and reported. As more individuals with HIV infection live longer and experience the aging process, clinicians, researchers and program developers must incorporate their unique health challenges into standards of care and programs to address their needs. Finally, much can be learned about chronic illness throughout the lifespan by examining the multigenerational experiences of families affected by HIV infection.