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In terms of behavioral factors, similar to younger and middle-aged people living with HIV, among OALH, substance use has been shown to be common, though patterns of current substance use are not well understood (Rabkin, McElhiney, & Ferrando, 2004). However, one study found that reported substance use rates within the past month among OALH in the New York City area were 74.3% for alcohol, 45.2% for cocaine/crack, 41.8% for marijuana, 15.4% for opiates, 11.7% for other drugs (i.e., amphetamines, sedatives, PCP, and solvents), and 9.5% for poppers (Parsons, Starks, Millar, Boonrai, & Marcotte, 2014). Nonetheless, there is some indication that substance use may decrease following HIV diagnosis, and more so among older as compared to younger people living with HIV (Montoya et al., 2016). In one study involving a sample of primarily male and African American older veterans, substance use was found to be significantly more common among those with HIV compared to those without HIV (e.g., approximately 45% among OALH vs. 30% among HIV-uninfected older adults) and associated with higher rates of medical and mental health difficulties (Green et al., 2010). Such findings highlight the need for both screening and the development and implementation of age-appropriate interventions aimed at reducing or ceasing substance use, in particular among OALH.

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