HIV and the Older Adult - A Growing Population
When we think of HIV we have certain populations in mind. We hear about its ravages on young men and women; on the gay and lesbian populations; on the homeless and the intravenous drug user. We seldom think about hiv and senior citizens. What no one talks about is HIV and the older adult. It's no wonder that when you talk to our senior citizens, they feel HIV is not a risk to them. Is HIV a risk to older adults. Is HIV over 50 a problem?
The truth of the matter is that HIV surveillance shows that 11 percent of all new AIDS cases are in people over the age of 50. Statistics also show that new AIDS cases rose faster in the over 50 population than in people under 40. The following information sheds light on HIV and the older adult population and what can be done to raise awareness, slow the infection rate, and sustain a high quality of life for our seniors.
What is the HIV Over 50 Myth?
There is a myth that contributes to the growing rate of HIV among the over 50 population.
"Seniors don't have sex and therefore aren't at risk for HIV."
Nothing could be further from the truth.
In fact studies from the early 1990s provided data that proved sexual desire does not wane after the age of 50. Experts report that more than half of persons over 50 are having sex a couple times each month. Unfortunately, knowledge of safer sex practices among seniors is much less than that of persons in their late teens and early twenties. This combination of facts explains in part why the HIV population among seniors continues to grow.
HIV Over 50 is Not New - But the Mode of Transmission Is
HIV among adults over 50 is not a new phenomena. Since the early 80's, HIV in persons older than 50 have accounted for about 10 percent of all cases. What has changed is the mode of transmission. In the early years of the HIV epidemic, blood transfusion was the major transmission mode among the senior population. Today, heterosexual contact and needle sharing among IV drug users older than 50 are the main causes of HIV infection in our seniors. The figures are staggering. Heterosexual transmission in men over 50 is up 94 percent and the rate has doubled in women since 1991. And while prevention and education dollars are concentrated toward young adult populations, seniors are not getting safer sex education and continue to get HIV infected.
What Can Be Done?
What the HIV medical community do to reverse this trend of a growing over 50 population that is infected with HIV. Interventions that will help include:
- Assess For Sexual Risk Factors
Change the traditional mode of thinking. Studies have shown physicians do not routinely assess for HIV risk factors in persons over 50. The incorrect belief that people over 50 do not have sexual risk factors for HIV is contributing to the incidence of unprotected sex among seniors and the lack of safer sex education directed at people over 50. For example The Senior HIV Prevention Project in Nairobi reports that many seniors still believe that HIV is transmitted only by blood transfusion and casual contact. This lack of HIV knowledge combined with the belief that safer sex is only for young women wanting to prevent pregnancy leads to at risk behavior among our elders. Without intensive education, post menopausal adults are less likely to discuss condom use, now that the risk of pregnancy is removed.
- Breakdown Stereotypes
Secondly, stereotypes must be broken down. Society stereotypes a homosexual man in his twenties or thirties. Because gay men are an at risk population, Prevention and education money is therefore directed to that groups. When in fact, gay men over the age of 50 is a growing population. People today are living longer, healthier lives, meaning the over 50 population is on the rise; including the number of gay men over 50. While young gay men have always been a target of prevention education, the prevention messages need to be adjusted to include the over 50 gay population. Proper and targeted prevention messages have been shown to have a bigger impact on behavior than does porly targeted education. -
- IV Drug Users Are Getting Older
The belief that IV drug users are younger adults couldn't be farther from the truth. The consensus used to be that IV drug users out grew their addiction, either by getting treatment or dying. The typical story goes something like this.
An older man develops a relationship with a younger, drug addicted woman. One thing leads to another and the seductive link between sex and drug use results in men over 50 trying drugs for the first time. Once addicted, the same rules hold true as they drug with young drug addicted persons. Sharing needles and "works" results in an increased risk of HIV transmission via needle sharing in the over 50 population.
Substance abuse treatment programs must consider this when developing substace abuse programs. Substance abuse rehab programs must include messages targeted to people over 50.
Today we are faced with new challenges in HIV treatment and prevention. We must take great effort in providing adults over 50 with the HIV prevention education they need to stay healthy. We must erase the myths and realize HIV can strike anyone. So many times our elderly are left to fend for themselves. We forget the contributions they have made and the respect they deserve. Society and the medical community must not forget our seniors. That much they deserve.
