Human Immunodeficiency Virus, HIV, is by no means a new topic of concern but it is a topic that should remain central to the health of the older adult population. Largely, older adults with HIV or at risk for HIV infection is an under-served and overlooked population although statistics show an increasing number of older adults are living with HIV.
We must confront the epidemiology of HIV infection among older adults – the distribution of the disease – specifically which older adults are affected; what factors contribute to them being at risk, and what should be done to control the spread of this health problem.
It is known that:
Among people aged 50 and older, 49% of new HIV diagnoses in 2015 were among gay and bisexual men, 23% were among heterosexual women, 15% were among heterosexual men, and 12% were among persons who inject drugs.
COMMON RISK FACTORS
Growing older – aging - is not a risk factor for HIV infection. In fact, the risk factors are the same for younger adults.
While a person’s age is not a risk factor, there are changes in the body of aging adults as well as behaviors that increase their risk. Namely, for older women, the thinning and dryness of the vagina can cause cuts and tears and make them more susceptible to HIV infection during sex without a condom with a partner who is infected. For older men, the use of penile enhancing drugs to counteract declining sexual functions supports their ability to continue sexual activity. In terms of behaviors, older adults who change partners for reasons related to separation, divorce or death and who begin dating again, may not use condoms for protection or may not know of the new partner’s HIV status.
Some of the challenges relative to HIV risk factors and older adults are that:
Certainly, these challenges can lead to new cases of HIV infection and even the older adult being diagnosed in the late stages of HIV infection or with AIDS. According to the Centers for Disease Control and Prevention, CDC, in 2014, 40% of people aged 55 and older had late stage infection (AIDS) at the time of HIV diagnosis (i.e., diagnosed late in the course of the infection).
CALL TO ACTION
HIV education and prevention services and opportunities for HIV testing must be a part of the continuum of care that the aging population receives. Agencies and institutions that serve older adults must continually evaluate HIV support services that older adults receive.
Health care providers treating older adults must take charge of the conversation and
Health care providers are checking the blood pressure, cholesterol level, feet, breast and prostate of older adult patients but are they testing for HIV infection?