December as AIDS Awareness Month presents a good opportunity to reflect on a group of people who faces some unique issues when living with HIV – older adults and seniors, Janette Wheat, Ph.D, said.
Wheat is an associate professor and Cooperative Extension Program human development specialist at the University of Arkansas at Pine Bluff.
While many HIV risk factors are the same for adults of any age, older people are less likely to get tested for HIV, according to a news release.
According to the Centers for Disease Control and Prevention (CDC), in 2016 nearly half the people living in the U.S. diagnosed with HIV were 50 and older, and in 2017 there were almost 7,000 new diagnoses in this age group. Though new HIV diagnoses are declining among this age group, it still accounts for one in six diagnoses.
Wheat said older people with HIV are frequently diagnosed much later than people in other age groups. For example, half the people aged 55 and older who received an HIV diagnosis in 2015 had been living with HIV for almost five years before they were diagnosed.
“Older people may not consider themselves to be at risk of HIV infection or may mistake HIV symptoms for those of normal aging,” she said. “A delay in diagnosis often means they start treatment late and suffer more immune-system damage. Late diagnoses can also occur because health care providers may not always test older people for HIV infection.”
Wheat said there are some behaviors that put everyone at risk for HIV. These behaviors include having anal or vaginal sex without protection (such as using a condom or taking medicine to prevent or treat HIV) or sharing injection drug equipment with someone who has HIV.
According to the CDC, older people may have many of the same HIV risk factors as younger people, including a lack of knowledge about HIV prevention and the sexual risk involved with behaviors such as having multiple sex partners.
Older people also face the following unique risk factors:
• Women who no longer worry about becoming pregnant may be less likely to use a condom and to practice safer sex.
• Age-related thinning and dryness of vaginal tissue may raise older women’s risk for HIV infection.
• Although they visit their doctors more frequently, older people are less likely than younger people to discuss their sexual or drug use behaviors with their doctors. And doctors are less likely to ask their older patients about these issues.
• Stigma may prevent individuals from disclosing their HIV status and seeking HIV care. This is a particular concern among older people because they may already face isolation due to illness or loss of family and friends.
• Aging with HIV presents special challenges for preventing other diseases, Wheat said. Both age and HIV increase the risk for cardiovascular disease, lung disease (specifically chronic obstructive pulmonary disease), bone loss and certain cancers.
“Older patients with HIV and their care providers need to maximize prevention efforts against these conditions and remain vigilant for early signs of illness,” she said. “It’s also important to be careful about interactions between the medications used to treat HIV and those used to treat common age-related conditions such as hypertension, diabetes, elevated cholesterol and obesity.”
According to the CDC, the organization and its partners are pursuing a high-impact prevention approach to maximize the effectiveness of current HIV prevention interventions and strategies among older Americans. Funding state, territorial and local health departments is CDC’s largest investment in HIV prevention.
Resources are available online for individuals living with HIV, health care providers and the general public at www.cdc.gov/hiv. Individuals can also call the CDC’s national health information hotline at 1-800-CDC-INFO (232-4636) to ask questions, receive resources and find out where to get an HIV test.
AIDSinfo, a service of the U.S. Department of Health and Human Services, offers access to the latest, federally-approved HIV/AIDS medical practice guidelines, HIV treatment and prevention clinical trials, and other research information for health care providers, researchers, people affected by HIV/AIDS, and the general public. The service can be reached by calling 1-800-HIV-0440 (448-0440) or emailing email@example.com.
The University of Arkansas at Pine Bluff offers all of its Extension and Research programs and services without discrimnation.
— Will Hehemann is a writer/editor with the UAPB School of Agriculture, Fisheries and Human Sciences.