James Bender was a Navy sailor. One night in Florida in the 1980s he met two female prostitutes, one of whom left him with a lifelong reminder of their encounter. Believing AIDS was a disease for gay white men, he hadn't worn a condom. A weeks-long fever in 1987 led to an AIDS diagnosis.
"AIDS made me quit taking life for granted. It forced me to make the best use of my time." — James Bender, 51
Now a longtime AIDS survivor, Bender, 51, has endured his share of struggles. The harsh early drugs that saved his life also contributed to a heart attack, osteoporosis, and neuropathy, a nerve-deadening condition of the hands and feet.
Since he began HAART, Bender has come down with the age-linked maladies diabetes, glaucoma, and an enlarged heart. That's because even when HIV is controlled with drugs, it still accelerates the body's aging process. The average 55-year-old with HIV has three chronic conditions — the same number as a 75-year-old who is HIV-negative. Within three years of infection, certain cells vital to the immune system age by as much as 20 to 30 years, a recent UCLA study found. Three U.S. research groups are collaborating to devise guidelines for treating older HIV/AIDS patients.
Bender wonders whether health systems will be able to care for aging people with the disease. He's not alone. Stephen Karpiak of ACRIA sees the coming wave of older AIDS patients as a potential catastrophe. "It's a tsunami that will flood our budgets and worsen the caregiving crisis that's starting to make itself known," he says. "We really need to get a handle on this."
Baltimore-based writer Michael Anft is senior writer for science and medicine at Johns Hopkins Magazine.