According to the organization UNAIDS, there are over 4 million people who are over the age of 50 who have HIV or were recently diagnosed with the HIV virus. Out of this amount, there is only about 50% that even know that they are HIV positive.
This means that 13% of all the people who have HIV are older adults. 6 of 10 people who are HIV positive come from the sub-Saharan Africa.
Originally, HIV started out as a disease that ran rampant in young men in the United States. However, today this epidemic is affecting both men and women of all ages. Even though 50 doesn’t seem old, it is often the age that is used by health organizations to track statistics. Almost 50% of people who are HIV positive inside of the United States are 50 years of age or older.
The most overlooked group is older women. Older women are often ignored in any discussion about HIV and preventative care and treatments. It is very important that older women, their families and doctors understand that this virus does affect this age group.
Women who are over 45 and HIV positive have become a growing population inside of the United States. 56% of women who were over the age of 45 and HIV positive were represented in 2013. In 2015 this number increased. 25% of older women made up the newer diagnoses of HIV were 50 or older. It is these numbers that are much smaller than the actual number of older women who are HIV positive. Most people never go to get tested for HIV and that means that they are never diagnosed, even though they could have been living with this virus for years.
Even though it is stated that older people just don’t have sex, most older women are still sexually active. There was a study done that showed 3 out of 4 older people aged between 57 and 64 were sexually active within the last year and over 50% of those were aged between 65 and 74. Older women are at a much greater risk for developing HIV because the vaginal walls will be much thinner and the vagina will be drier than someone who is much younger. This can actually cause the vaginal area to tear.
There are a lot of older women who are older than 50 who are actively thinking about dating after their partner dies or a long-term relationship ends. Women who are often very monogamous for years are not being sexually active with new partners and are not thinking about being at risk for HIV. They could feel uncomfortable when discussing STDs/STIs or even safer sex with their partner or doctor and they may not know the best methods to use in order to protect themselves.
Older women may not even be aware of the newer methods of prevention for HIV like PrEP or Pre-exposure prophylaxis which is where you take HIV medications before you are exposed to HIV which prevents you from getting the virus.
There are many older women who have already gone through menopause and so they do not feel the need to use condoms as a form of birth control. Yet, condoms can prevent you from spreading or catching STDs/STIs at any age.
If an older woman is HIV positive, then they are more likely to be isolated and invisible. They will often keep their status hidden from their family and friends. They are often afraid to disclose their status because of the stigma that is around being HIV positive.
There are many people who are a part of the HIV community that are not aware of HIV among older people, and this goes for women the most as this age group has been left out of HIV clinical trials, research and prevention education.
Older people who are IV drug users will always be at risk for contracting HIV from sharing drug equipment and needles.
Older people are not tested for HIV routinely. Many doctors can feel uncomfortable asking an older person about sexual behaviors or they could believe that older people are not sexually active. Whenever an older patient is showing flu like symptoms, most doctors would never think to test for HIV. This means that older people are often not diagnosed as being HIV positive until they are in advanced stages of HIV.
There are a lot of things that an older person can do in order to stop the spreading of HIV and live much healthier at an older age.
First off, you have to know that it is really important to make sure that older people have the right information about HIV such as what it is, how it can be transmitted and treatments for it.
Age will not protect a person from getting or even transmitting HIV to another person. When you practice safer sex, you are able to reduce your risks of getting HIV. If you are injected drugs, then always use a clean needle.
In order for there to be prevention of HIV in older people, they need to know and understand that there is a need for early diagnosis and routine HIV testing. The CDC has started to recommend that all people ages 13 up to 64 get screened routinely for HIV in all healthcare instances. If you are over 64, then you still need to be tested for HIV, especially if you are sexually active still. The CDC also recommends that all doctors encourage their patients and even prospective sexual partners to get tested for HIV before a new sexual relationship is started.
If you believe that you have potentially been exposed to HIV, no matter how old you are, get tested and talk about PEP or Post exposure prophylaxis with you doctor. PEP means that you are going to take medications for HIV to prevent getting HIV after you are exposed to it. These medications will need to be taken within 72 hours being exposed and it has to be taken for 28 days or 4 weeks.
If you have tested positive for HIV, then do not give up. When you have a good HIV drug regimen and you keep a positive attitude, then you can live until you are near your 100s. HIV is a manageable but chronic condition. If you are HIV negative, you are able to gain the knowledge on how you can stay that way. Also, knowing your HIV status is a very big thing to do in order to prevent transmitting HIV to any other person that you may care about.
Unfortunately, older people are often not provided HIV information. People do not see the face of someone who is older on HIV prevention posters. Social service providers and doctors need to know that aging patients are still at risk for HIV. Doctors need to ask their patients about drug and sexual histories.
Older people also need to be open to their doctors about using IV drugs or having sexual risks that may have put them at risk, as well as any sexual or physical violence that they may have experienced in life. Don’t be afraid to mention any situations or events that you think could have put you at risk for getting HIV like getting a tattoo without being 100% positive that a sterile and disposable needle was used. When you provide your doctor with accurate information, then you are providing a great way to protect your health and ensuring that you are receiving great medical care.
There are several ways that being older and living with HIV is different from normal aging. Heart disease is still an often-unrecognized cause for death and illness among older people, with or without HIV.
Written by Mark Riegel, MD
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