More Seniors Are Living With HIV/AIDS
December 1 is World AIDS Day, when health agencies worldwide call attention to the fight against HIV infection, and the need to support people who are living with the HIV virus.
HIV stands for human immunodeficiency virus. If not treated, it can lead to acquired immunodeficiency syndrome, or AIDS. There is at present no cure for HIV, but it can be controlled.
Many people are under the impression that HIV/AIDS is a young persons’ disease, but in fact, the Centers for Disease Control and Prevention (CDC) has predicted that by the end of the decade, up to 70 percent of people living with the virus will be age 50 and older.
Why so many seniors?
Many of today’s older patients contracted the virus before there was widespread awareness of how to prevent transmission. Fortunately, the development of more effective drug therapies in the 1990s has allowed them to survive and thrive into their later years. Experts speak of “the graying of our nation’s HIV epidemic.”
Older adults also continue to be at higher risk of contracting the virus. They may be less aware of the disease and how to protect themselves. For example, after years of a monogamous marriage, they might be widowed and dating again, unaware that they should take precautions to avoid infection. Women who no longer worry about pregnancy are less likely to use a condom—yet age-associated physical changes make their bodies more susceptible to transmission of the virus. Seniors are also less likely to talk frankly with their doctor about sexual health or drug use.
Like people of any age, older adults should take precautions to avoid being infected. They should avoid having unprotected sex. They should know their partner’s drug and sexual history. They should avoid sharing a needles and other equipment to inject drugs. The National Institute on Aging (NIA) says that people who had a blood transfusion between 1978 and 1985 may also be at risk.
Seniors less likely to be tested
HIV can be diagnosed with a simple test. The cost of the test is covered by Medicare. Talk to the doctor or other health care provider about the type and frequency of testing.
Seniors are less likely to be tested for the disease. Often doctors fail to recommend testing for older patients—and older patients may be too embarrassed to ask for a test. Seniors who notice symptoms that are associated with HIV, such as weight loss, pneumonia, fatigue, confusion or vision problems, might chalk up these symptoms to the normal aches and pains of aging, or to other health conditions they’re already living with. And they might hide their concerns, fearing the reaction of loved ones and caregivers—both to their diagnosis, and to the behaviors through which they contracted the infection.
Early diagnosis is so important
The NIA says, “Once effectively a death sentence, HIV infection can now be considered a serious, but largely manageable, chronic condition.” Back in the day, HIV/AIDS was thought to be a certain, swift death sentence. Today, people with HIV can live long, healthy lives. Antiretroviral therapy (ART) can suppress the virus for years, and today’s improved drugs are easier to manage, with fewer side effects.
The earlier treatment begins, the better. Managing HIV is more complicated when patients are older, and in turn, HIV complicates aging. One study found that 94 percent of older adults with HIV in the U.S. have at least one other chronic illness; the average is three. The medications prescribed to treat HIV may interact with drugs prescribed to treat common age-related conditions, such as obesity, diabetes, elevated cholesterol and high blood pressure.
HIV raises the risk of many age-related health conditions, as well. It causes chronic inflammation, which can lead to heart disease, osteoporosis, diabetes, liver disease and certain cancers. Research continues to confirm that HIV raises the risk of dementia. According to the NIA’s Dr. Miroslaw Mackiewicz, “HIV hits the brain early, continuously, and hard.” Research is ongoing to find ways to better protect the memory and thinking of people living with HIV.
The social cost
HIV treatment saved the lives of many people with HIV—only to leave them with financial challenges. At the beginning of the epidemic, a person could expect to live only for one or two years after diagnosis. So many people who were infected, not thinking they would live to old age, didn’t plan for their retirement. It’s important to learn about special Medicare, Medicaid and Social Security benefits for people with HIV.
Seniors are also more affected by the stigma faced by people with HIV, which increases feelings of loneliness, depression and isolation. “Many older people living with HIV have learned to live with stigma, and have learned where it is safe or not safe to disclose their status, and potentially have found long-term partners who have accepted their status,” said University of Pennsylvania Professor of Infectious Diseases Dr. Helen Koenig. “But in many ways I believe they still face the same degree of stigma that younger people living with HIV and even people who were living with the virus in the 1980s and early 1990s faced.”
Overcoming the stigma is a great way to support these older adults. Dr. Koenig reminds us, “The stigma is not their problem, it’s our problem, a problem within our society that we need to continue to confront at every level.”
The information in this article is not intended to replace the advice of your healthcare provider. Talk to your doctor about the prevention and treatment of HIV.