HIV / AIDS after 50: What You don't Know Can Kill You

50+ Issues: "Almost 20% of persons living with HIV / AIDS in the United States are 50 years of age or older. Here's what you need to know."

Outrageous and upsetting news!

Almost 20% of persons living with HIV / AIDS in the United States are 50 years of age or older.

Three distinct groups.

The advent and wide availability of Highly Active Antiretroviral Therapy (HAART) in the developed world has extended the life expectancy for people living with HIV/AIDS, and has thereby created several distinct populations of older adults in relation to HIV disease.

1. The newly infected.


First are those older adults who have become newly infected with HIV in later life.



2. Long term survivors.


Second, are the long term survivors, who were infected much earlier and are now able to grow old with HIV/AIDS due to the tremendous advancement in HIV treatment.



3. HIV negative people engaging in risky behavior.


Third are those older adults who may be HIV negative, but are unaware of their risk for infection, engaging in behaviors that increase their risk for exposure to HIV.

We know through research that compared to younger persons, those 50+ are less likely to use condoms or practice methods of safe sex. They are less likely to be tested for HIV, or to know their own HIV status.

Misconceptions and ageist attitudes.


Misconceptions and ageist attitudes about aging and sexuality continue. Older people are seen as asexual, heterosexual and monogamous by society and health care providers.

Yet older adults are exposed to HIV by the same means as younger persons.

These risk factors will certainly continue to increase in the coming years with the aging of the Baby Boom generation and their generational mindset related to drug use and sexuality.

Social, physical and psychological challenges.

Once infected with HIV disease, older adults experience multiple social, physical and psychological challenges that negatively impact their quality of life.

Social Challenges.

As we age, our social resources may decline through loss of friends, family and other informal supports. Research has consistently found that older adults with HIV/AIDS have a very high likelihood of living alone.

Such living arrangements may result in social isolation and limited assistance with physical care needs which may in turn exacerbate psychological problems such as depression. Becoming HIV infected may result in a severing of social ties from family and friends.

As one 51 year old man stated, "You feel more closed …You just don't feel like you can socialize anymore."

Physical Challenges.

While the management of HIV disease is a challenge for most individuals, older adults have the added complication of possibly having more than one diagnosable condition at the same time.

The physical well- being of older persons may be impacted not only by HIV, but also by age-related diseases such as arthritis, non-HIV related respiratory or cardiac disease, or other disease processes.

While older persons with HIV/AIDS have been found to be more compliant with HIV medications than their younger counterparts, there is an increased likelihood of drug-drug interactions between HIV medications and those prescribed for other medical conditions.

Simply put, HIV complicates the already difficult process of managing age related disease processes.

Psychological Challenges.

While many older adults living with HIV/AIDS have adjusted well to their illness, a sizable minority of HIV-infected older adults confront a variety of psychological issues.

In a National Institute of Mental Health study, 32% of the HIV infected older adults interviewed voiced symptoms of depression. The psychological impact of the disease is compounded by internalized stigma emanating from an AIDS phobic society.

One 72 year old man interviewed stated, "You don't what people to know you have this dreaded disease…I would rather get run over by a truck than die of AIDS. That's what I'm hoping for; I'm hoping that nobody else finds out."

Late detection.

Rates of HIV infection (not AIDS) in seniors are especially difficult to determine because older people are not routinely tested.

Most older people 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.

The double stigma.

Older people with HIV/AIDS face a double stigma: ageism and infection with a sexually-or-IV-drug transmitted disease.

Because of the stigmas, it can be difficult for seniors---women, in particular---to disclose their HIV status to family, friends and their community.

Heterosexual infections on the rise.

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.

HIV and older women

For women over 50, 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.

Age symptoms confused with HIV symptoms.

As HIV symptoms often are similar to those associated with aging (fatigue, weight loss, dementia, skin rashes, and swollen lymph nodes), misdiagnosis is frequent in older people who are, in fact, infected.

The lack-of-support syndrome.

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.

The sin of omission.

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.

Cases of new HIV infection among older persons will continue and likely increase for the foreseeable future, while increasing numbers of people will live into old age with HIV/AIDS.

It is incumbent upon us to provide improved systems of care for these individuals. <<

For other articles of interest to those over 50 (seniors and boomers) visit www.LetLifeIn.com. With a cutting edge and a (sometimes irreverent) sense of humor, LetLifeIn.com explores all aspects of being 50+ -- the concerns, the issues, and the controversies as well as the fun stuff.