{"id":69273,"date":"2023-03-28T13:15:48","date_gmt":"2023-03-28T19:15:48","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=69273"},"modified":"2026-04-02T15:25:53","modified_gmt":"2026-04-02T21:25:53","slug":"positive-aging-clinic-offers-geriatric-and-hiv-care","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/positive-aging-clinic-offers-geriatric-and-hiv-care\/","title":{"rendered":"The Positive Aging Clinic addresses the HIV and primary care needs of patients 50 and older"},"content":{"rendered":"
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\"Jim
Jim Malatchi with a longtime 12-string friend. Photo courtesy of Jim Malatchi.<\/figcaption><\/figure>\n

During the summer of 2022, Jim Malatchi returned to Boise, Idaho for his 60th<\/sup> high school reunion. As he remarked, a surprising number of his classmates were still around to attend. The biggest surprise may have been that Malatchi himself was an attendee.<\/p>\n

On an afternoon 30 years before the reunion, Malatchi visited a Denver-area dermatologist\u2019s office seeking care for a patch of foot fungus. Malatchi agreed to routine blood work before treatment as well as a test for the human immunodeficiency virus (HIV), which can cause acquired immune deficiency syndrome (AIDS).<\/p>\n

He was stunned when the HIV test came back positive. Malatchi was 49, straight, married and didn\u2019t use drugs. His life was stable. He had forged a successful early career as a musician and later as a builder and designer of sound equipment for music venues in the Denver area and lighting systems he distributed around the country.<\/p>\n

\u201cI couldn\u2019t quite process the diagnosis,\u201d Malatchi recalled.<\/p>\n

The shock deepened when he met with an infectious disease specialist whose first words were, \u201cThere is no cure.\u201d It was 1992, and the only HIV medication available was AZT, which had shown some success in preventing the virus from replicating, but also carried difficult side effects<\/a>. Malatchi started taking AZT, the start of a grueling fight that included a diagnosis of AIDS. Three different times, specialists told him he had six months to live.<\/p>\n

Malatchi defied those predictions. Thanks to his own determination and remarkable medical advances in HIV treatments, he has not merely survived; he has thrived.<\/p>\n

Not so long ago, that would have made him part of a vanishingly small group. No longer. Today, Malatchi is part of a rapidly growing community: HIV-positive individuals 50 years of age and older. They now account for more than half of all people living with HIV<\/a>. The gift of life, however, comes with the common challenges of advancing age \u2013 creaky joints, frailty, fading vision and the like \u2013 as well as heightened risks linked to the virus.<\/p>\n

Care for a growing HIV community<\/strong><\/h2>\n

The recently launched Positive Aging Clinic at UCHealth University of Colorado Hospital<\/a> aims to help older people with HIV address their varied and often complex health concerns. The clinic, which opened in late 2022, is an extension of a collaboration that began in 2019 between the UCHealth Seniors Clinic<\/a> and UCHealth Infectious Disease Clinic<\/a> to care for older adults with HIV through joint consultations. The new clinic is one of only a handful in the country that offers geriatric and HIV care at one site.<\/p>\n

\u201cWe address the advanced care needs of older adults in this unique population,\u201d said clinic director Dr. Jacob Walker<\/a>, a dually trained geriatrician and HIV specialist and assistant professor of Medicine-Geriatrics at the University of Colorado School of Medicine<\/a>. \u201cBeing an HIV specialist [as well as] a geriatrician, I can further consolidate their care into one unit and integrate it as much as possible.\u201d<\/p>\n

\"Dr.
Dr. Jacob Walker, a dually trained geriatrician and HIV specialist and assistant professor of Medicine-Geriatrics at the University of Colorado School of Medicine.<\/figcaption><\/figure>\n

Jim Malatchi, who recently had his first clinic appointment with Walker, understands that approach. He said he has been satisfied with the care he\u2019s received separately in the UCHealth Seniors Clinic and in the UCHealth Infectious Disease Clinic. However, at 79, health issues are a regular presence. For example, he recently had his gallbladder removed and endured a painful recovery. His knees are balky. He manages multiple medications for his HIV, heart disease and other conditions. He looks forward to Walker helping him stay on top of it all.<\/p>\n

\u201cI\u2019ve had nobody to take a look at the big picture and manage all the specialists I\u2019m seeing,\u201d Malatchi said.<\/p>\n

Bridging the geriatric-HIV gap<\/strong><\/h2>\n

As a geriatrician, Walker can help older people with HIV manage common aging concerns. The issues include frailty, fall risk, osteoporosis, cognitive decline, dental problems and hearing and vision loss.<\/p>\n

\u201cFor a lot of patients, their only primary care has been through their HIV clinic,\u201d Walker said. \u201cThere is a lot they haven\u2019t had a chance to talk with their physicians about or thought to. We can hit a lot of low-hanging fruit, such as just getting them to an eye doctor or the dentist.\u201d<\/p>\n

At the same time, older adults with HIV have \u201cparticular problems\u201d related to their HIV that \u201cput an extra layer on top of the unique medical features that a lot of older adults experience,\u201d he said.<\/p>\n

Walker divides that layer into three categories. First, many people with HIV have earlier onset of common age-related illnesses, such as osteoporosis. Second, these patients also deal with higher rates of some conditions, such as heart disease<\/a> and depression<\/a>, than those without HIV. Finally, Walker addresses HIV-specific problems that include certain types of cancer, such as lymphoma<\/a>; social stigma; and cognitive impairment<\/a> that is \u201cspecifically associated with HIV.\u201d<\/p>\n

The health care system itself adds another worrisome wrinkle for older HIV patients, Walker added. These include barriers to insurance and advanced care planning. All of the issues may be exacerbated by social isolation, which can worsen people\u2019s medical and mental health.<\/p>\n

A thorough health review for older adults with HIV<\/strong><\/h2>\n

Given the range of issues his patients may face, it\u2019s not surprising that Walker spends at least one hour with them on the initial visit. He gathers information in key areas that include:<\/p>\n