HIV and AIDS Are Real Risks for The Over 50s

Robert W. Griffith, MD
July 2, 2004

This article is taken, with permission, from the National Association on HIV Over Fifty (NAHOF) website. NAHOF was founded at the National Conference on AIDS and Aging in October of 1995 in New York City. Their mission is to promote the availability of a full range of educational, prevention, service and health care programs for persons over age fifty affected by HIV. Robert Griffith, Editor

Facts About HIV and AIDS in Older People

• Between 11 and 15% of U.S. AIDS cases occur in people over age 50.
• Numbers of cases are expected to increase, as people of all ages survive longer due to triple-combination drug therapy and other treatment advances.
• Between 1991 and 1996, AIDS cases in the over-50 population rose more than twice as fast as those among younger adults.
• Older individuals with HIV infection or AIDS usually are invisible, isolated and ignored.
• Despite myths and stereotypes, many seniors are sexually active, and, some are drug users; therefore, their behaviors can put them at risk for HIV infection.
• Health care and service providers--and older adults, themselves--do not realize that seniors are at the same risk as other age populations; professionals often are reluctant to discuss or question matters of sexuality with aging patients/clients.
• Rates of HIV infection (not AIDS) in seniors are especially difficult to determine because older people are not routinely tested.
• Most older persons are first diagnosed with HIV at a late stage of infection, and often become ill with AIDS-related complications and die sooner than their younger counterparts; these deaths can be attributed to original misdiagnoses and immune systems that naturally weaken with age.
• HIV/AIDS educational campaigns and programs are not targeted at/to older individuals (how often does a wrinkled face appear on a prevention poster?).
• Seniors are unlikely to consistently use condoms during sex because of a generational mindset and unfamiliarity with HIV/STD prevention methods.

Special Considerations

• While men who have sex with men form the largest group of AIDS cases in the over-50 population, the number of cases in women infected heterosexually have been rising at a higher rate and comprise a greater percentage as age increases into the 60s and older.
• Because of the stigma, it can be difficult for seniors - women, in particular - to disclose their HIV status to family, friends and their community.
• For older women, there are special considerations: after menopause, condom use for birth control becomes unimportant, and normal aging changes such as a decrease in vaginal lubrication and thinning vaginal walls can put them at higher risk during unprotected sexual intercourse.
• As HIV symptoms often are similar to those associated with aging (fatigue, weight loss, dementia, skin rashes, swollen lymph nodes), misdiagnosis is frequent in older people who are, in fact, infected.
• HIV-infected seniors are sensitive to a cultural attitude that assumes: "Elderly people have lived their lives - so what if they die from AIDS?"
• Older individuals may confront social and professional bias regarding the allocation of limited health care services and resources available to the AIDS community (i.e., "why waste money on the elderly?").
• Because the aging process itself lowers energy levels and results in restrictions in social routines which can cause emotional/psychological problems, the older adult additionally infected with HIV may feel another "loss" and endure more severe depression.
• Seniors often are less likely to find support and comfort among family and friends, and because they are traditionally not comfortable in support groups, they may be less inclined to join them, citing lack of shared experiences concerning different issues.
• Due to the general lack of awareness of HIV/AIDS in older adults, this segment of the population, for the most part, has been omitted from research, clinical drug trials, educational prevention programs and intervention efforts.

Necessary Action

• Specific programs must be implemented for older adults who need to be informed about the transmission and prevention of HIV.
• Outreach should include workshops and trainings devoted to basic HIV/AIDS information, "safe" sexual and drug-using practices, testing, negotiation skills -all in relationship to aging.
• More research is needed to study seniors' sexual and drug-using behaviors and to determine HIV disease progression and treatments in the over-50 population.
• Health care and service providers on all levels should be educated on HIV risk behaviors and symptoms of HIV infection; they need to conduct thorough sex and drug-use risk assessments with their older clients/patients.
• Programs aimed at reaching health care and service providers should cover misdiagnoses, testing technologies, treatments, support groups, case management and the importance of being actively involved in the health and well-being of their older clients/patients.
• Successful media and social marketing campaigns can raise awareness of HIV/AIDS in older people and reinforce the need for educational programs, while promoting respect and validation for the elderly as a group.

Source

• The National Association on HIV Over Fifty (NAHOF) website accessed on 5/22/04 at: http://www.hivoverfifty.org/index.html

Related Links
National Association on HIV Over Fifty (NAHOF)
HealthLink: The Other, Older Face of AIDS

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