Photo by Gabrielle Revere
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HIV Over 50
By Nancy Gottesman, July & August 2005
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Forget the adage "older but wiser" when it comes to knowing the
facts about the transmission and prevention of HIV/AIDS. In a recent study
conducted at Emory University in Atlanta, 514 women ages 50 and older were
asked nine questions about their HIV risks. Only 13 percent said condoms were
effective prevention; 63 percent inaccurately stated kissing is a mode of
transmission; about half believed vasectomies provide protection; and, most
surprising, 44 percent said abstinence was not at all or only somewhat
effective in preventing HIV.
Meanwhile, the number of older Americans with HIV/AIDS is rising steadily.
According to Centers for Disease Control and Prevention figures for the years
2000 through 2003, an estimated 30,000 men and women were 45 or older at the
time of their diagnosis of HIV—the infection that causes
AIDS—comprising 23 percent of the total diagnoses during those years. And
despite popular misconceptions, not all were exposed by male-to-male contact or
injection-drug use. Indeed, Americans 45 or older accounted for 30 percent of
all those diagnosed with AIDS in 2002 who had been infected through
heterosexual sex.
There are two explanations for the rise of HIV/AIDS in older Americans, says
Adam Zweig, M.D., a staff physician specializing in HIV/AIDS at the Scripps
Clinic in San Diego, California. "First, people are now living longer with
HIV. Second, an increase in risky sexual behavior [such as not using condoms].
There's been so much success treating the infection, the fear factor is
gone."
But there's a cruel irony in this success for older HIV-positive
patients. "About 60 to 70 percent have another chronic
condition—liver problems, diabetes, high blood pressure," says Kathy
Nokes, Ph.D., R.N., a professor at the Hunter-Bellevue School of Nursing and
chair of the New York Association on
HIV Over Fifty. As it happens, many HIV medications have side effects that
can exacerbate these existing conditions, putting patients at increased
risk.
Unfortunately, few HIV education campaigns target older Americans.
Heterosexual women 50 and older in particular need to get the safe sex message,
says Jane P. Fowler, founder and director of HIV Wisdom for Older Women, a national program
of prevention and support. Most stop using protection because birth control is
no longer an issue. But after menopause, a decrease in lubrication and a
thinning of the vaginal walls put them at higher risk for HIV transmission.
Today, when Fowler speaks to groups of older men and women, she stresses safe
sex with an emphasis on condom use: "You never know the sexual history of
anybody else. Men, if you can get it up, cover it up!"
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