HIV in People Over 50
The possibility of becoming infected with an incurable disease never occurred to Jane Fowler when, after her divorce, she had a sexual relationship with an old family friend. A blood test for an insurance policy alerted the 55-year-old journalist that she was infected with ]]>HIV]]>, the virus that causes AIDS.
What Is HIV/AIDS?
The HIV virus weakens the body's immune system, leaving patients vulnerable to infections, cancers, and other diseases. People infected with HIV may not appear ill or suffer from any serious symptoms for years, and may, in fact, appear perfectly healthy. But people with HIV can pass the virus to others through sexual activity or sharing of needles. Casual contact, however, does not increase risk. The virus lives in bodily fluids, not on things, so activities such as sharing silverware, hugging, using a public toilet, or shaking hands do not increase your risk of contracting the virus.
Older Adults Less Knowledgeable of the Risks
Most older adults contract the virus through sexual contact—about half the men do so through homosexual encounters. But more older adults contract the disease through heterosexual contact than do their younger counterparts. In general, this mature group remains less knowledgeable than teens and young adults about the virus, its risks, and the ways to prevent it. Fowler is doing her part to educate older adults by taking to the road and sharing her story. She also founded an organization called HIV Wisdom for Older Women.
Unique Risks for Older Adults
While the majority of older Americans do not participate in behaviors that increase their risk for contracting HIV, some do. Unprotected sex is one of the most common causes. A few physical and social factors also add to older adults' risk, including:
- Menopausal and postmenopausal women can experience vaginal dryness and thinning, which can lead to cracks that allow easier access for the virus to enter the body.
- Older adults may associate ]]>condoms]]> with pregnancy prevention, rather than with disease prevention.
- Divorced or widowed adults who are new to the singles scene may be naive to the risks of unprotected sex and may be less likely to bring up the subject.
- Lonely adults may seek out sex with promiscuous mates or prostitutes.
- Some people may think, mistakenly, that current drug treatments are a cure.
- Some may view the golden years as a time to enjoy themselves and ignore the dangers, not realizing how the disease could affect their quality of life.
Many successful prevention programs have been administered to people in retirement communities, at health fairs, as well as other places older adults gather. The programs use age-appropriate materials and adapt public outreach messages to address the needs of an older audience. They also recruit mature adults to pass along the message.
"We make the presentations fun," says John Gargotta, of Florida's Senior HIV Intervention Project. "Older volunteers and staff are what make our program work so well. They create a dialogue and atmosphere where people are comfortable asking questions."
There are several ways to reduce risk for contracting HIV, including:
- Keep condoms handy and always use a latex condom or a female condom during sex with someone whose disease status you do not know. Think of it as having sex not just with this person you trust and think you know, but with everyone your partner has had sex with.
- Learn how to talk about sex and to negotiate protective barriers with potential partners.
- Do not share any kind of needles.
"If anybody has put him or herself at risk, get tested," Fowler says. "I feel like I was blessed that I 'flunked' the insurance company blood test when I did and found out I was infected. Had I not, I might be dead of AIDS today." Early treatment improves the odds of living with the disease.
Talk to Your Doctor
Routine blood tests do not include an HIV test, and some doctors might not consider ordering an HIV test when older patients comes in for a visit. Do not wait for your doctor to introduce the subject. If you think you may be at risk, ask for an HIV test and discuss the risks with your doctor. If you would like anonymity, consider getting an anonymous test, which many public health departments offer.
Center for AIDS Prevention Studies
National Association on HIV Over Fifty
Canadian AIDS Society
Canadian HIV/AIDS Information Centre
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HIV, AIDS, and older people. National Institute on Aging website. Available at: http://www.nia.nih.gov/HealthInformation/Publications/hiv-aids.htm. Updated March 2009. Accessed April 15, 2010.
Levy, JA, Ory, MG, Crystal, S. HIV/AIDS interventions for midlife and older adults: current status and challenges. J Acquir Immune Defic Syndr. 2003; 33 Suppl 2:S59.
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Last reviewed May 2010 by ]]>Brian Randall, MD]]>
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