More Seniors Living With HIV

(WebMD) A growing number of older Americans are living with HIV and AIDS, but few may be receiving advice on how to avoid spreading the disease, experts told lawmakers last week.

Infection rates aren't increasing in either younger or older people, health officials say. But the widespread use of antiretroviral drugs in patients in the U.S. has greatly extended the lives of AIDS patients and caused many more to live into later years. Today in the U.S., 28 percent of those living with HIV/AIDS are over the age of 50, and by 2015 that will increase to 50 percent, said Sen. Gordon H. Smith (R-Ore.)

Figures from 32 states show that the number of persons over 50 with HIV or AIDS went from 40,000 in 2000 to more than 67,000 in 2003, according to the Centers for Disease Control and Prevention. Older blacks are 10-15 times more likely than their white counterparts to be infected.

Unique Challenges
The agency remains worried that this growing segment of the population of HIV/AIDS older adults could provide a new reservoir for the spread of HIV.

"One of the challenges in people 50 and older is the mistaken belief that they're not at risk," Robert S. Jannsen, MD, director of CDC's division of HIV/AIDS prevention, told members of the Senate Committee on Aging.

Jannsen warned that older patients, raised before the AIDS emergence of the 1980s that made "safe sex" a buzzword among youth, are less likely to see the importance of using condoms. The fact that pregnancy is not a concern for most women over 50 may also make them less likely to think of condom use, he said.

Stereotypes and lack of awareness about the disease is another challenge in preventing the spread of the disease, added Smith.

Many doctors may also be reluctant to think of their older patients as sexually active. Studies suggest that only 30 percent-40 percent of younger patients are asked by their doctors about sexual history or practices, a rate that is almost surely lower for patients over 50, Jannsen said.

As the numbers of seniors living with HIV continues to grow, so too will the demand for services, they noted.

Jeanine Reilly, executive director for Broadway House for Continuing Care in Newark, N.J., said the average age of patients at the long-term care facility for AIDS sufferers has increased from 31 to 44 in the last four years.

"This is a much bigger danger than most people are aware of," she told WebMD. Reilly also complained that Viagra and related drugs have encouraged older people to have more sex without a corresponding increase in safe sex education.

"Baby boomers are not relinquishing their sexuality simply because they are getting older," she said. "The message about the threat of HIV/AIDS is not there."

Smith, who leads the aging committee, said he was likely to add provisions for improved AIDS education for older persons when Congress considers the reauthorization of the Ryan White AIDS Care Act later this year.

Sources: Robert S. Jannsen, MD, director, division of HIV/AIDS, CDC. Jeanine Reilly, executive director, Broadway House for Continuing Care, Newark, N.J. Sen. Gordon Smith (R-Ore.).

By Todd Zwillich
Reviewed by Brunilda Nazario, MD
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