HIV over 50 (HIV IN OLDER FOLKS, 2009)
Mar 25, 2009
Hello, Do you know what strategies or prevention efforts have been done to address the individuals over 50 that are getting the virus? What prevention efforts do you think will be effective in the prevention of HIV in this population?
Response from Dr. Frascino
The strategies are the same: Increase HIV/AIDS awareness and safer-sex prevention techniques. Some folks over 50 don't realize they are at risk. (One wonders where the hell they've been for the past 27 years, but nonetheless . . . .) Consequently, targeted HIV awareness and prevention campaigns are needed. Dubya and company eviscerated many HIV prevention programs here in the U.S., because they dared mention something as shocking as gay sex or prostitutes. His anti-science, sex-phobic attitudes have set HIV prevention methods back a decade. President Obama has recently appointed Jeffery Crowley to head the office of National AIDS Policy (ONAP). He will coordinate the federal government's efforts on HIV/AIDS policy. Crowley is a Senior Research Scholar at Georgetown University's Health Policy Institute. Prior to that post he was Deputy Executive Director for Programs at the National Association of People with AIDS overseeing the organization's public education programs, community development and training activities. In other words he's both smart and experienced!
I'll reprint some information from the archives that deals with HIV in the over-50 crowd.
data & longevity Jun 22, 2007
thank you for all the insightfull information. I am compelled to write again. I was dianosed 1 yr ago on the 25th anniversary of HIV. (Not the best celebration for me!) I am in my very late 40s and am very sensetive to the nearing turn, its effect on me, my hiv, and longevity.
Do we really know that much about people with hiv over 40? It seems that more people like me are getting infected and we really have no idea of the future for us? Regular aging mixed with HIV, meds, and OIs, etc?? Can you shed some light.
I do love this site, but I must admit, I'd like to see a section/sections on POSITIVE results. I need the doses of reality provided by the questions and answers but many times I could use a "shot in the arm" or some good news, good results!
Is there any information/ site that has data on HIV infected over 50?
Thanks for all your continued help.
Response from Dr. Frascino
First off, I must point out that 50 is the new 30. Next, we are continuing to accumulate data on "HIV-Daddies" year by year as more of us survive into our midlife crisis years. At this point all the news is "positive," so to speak. I see no reason you shouldn't plan on dying of old age. As a good friend who is also virally enhanced recently told me, "I plan to live forever. So far so good."
I'll print some basic information about HIV in older folks below.
Stay well. See ya in the old folks' home, OK?
Older People and HIV
How Many Older People Have AIDS?
About 78,000 people age 50 or over have AIDS in the United States. This is about 10-15% of all people with AIDS. In some cities, 15-25% of people with AIDS are 50 or over. The number of older people diagnosed with AIDS is increasing. About half of the older people with AIDS have been infected for one year or less. Many people don't consider age 50 to be "old." However, age 50 is being used more often to keep statistics on "older people" with HIV and AIDS.
Why Are Older People Getting Infected?
There are several reasons: Health care providers may not test older people for HIV infection Older people may lack awareness of the risk factors for getting HIV (see Fact Sheets 150 and 152) Many older people are newly single. They get divorced or lose their mates. While they had a partner they may have ignored HIV prevention messages.
Lack of HIV prevention education targeted at older people Belief that HIV only affects younger people No training in safer sexual activities (see Fact Sheet 151) Sharing needles with infected people (about 17% of infections of people over 50)
Unprotected sexual activity. This may be heterosexual or homosexual sex. Viagra and other drugs that help men get and maintain an erection may contribute to increased rates of sexual activity and sexually transmitted diseases among older people, as they do for younger people.
Is HIV Disease Different for Older People?
The first studies of HIV in older people were done before strong antiretroviral drugs (ARVs) were available. Most of them showed that older people got sicker and died faster than younger people. This was thought to be due to the weaker immune systems of older people. Also, older people usually have more health problems besides HIV. Normal aging leads to a decline in the immune system. Older people still tend to have long-term health problems. They may not do as well as younger patients with HIV. However, ARVs strengthen the immune system. Also, most older patients, unless they are drug users or have mental problems, take their medications more regularly (have better adherence, see Fact Sheet 405) than younger patients.
Is HIV Treatment the Same in Older People?
ARVs seem to work the same in older people as in younger people. Unfortunately, we don't have good information on older people because they were usually not included in clinical trials of new drugs. People who become infected when they are over 50 seem to do about as well as people who started receiving HIV treatment before age 50 and then got older.
Treatment side effects may not be any more frequent in older people. However, changes caused by aging can resemble or worsen treatment side effects. For example, aging is a major risk factor for heart disease and for increasing fat in the abdomen. Some older people without HIV lose fat in a way that looks similar to the changes caused by lipodystrophy.
What Other Health Problems Are Common?
As people age, they develop health issues that continue for the rest of their lives. These can include heart disease, depression, osteoporosis (see Fact Sheet 557), high blood pressure, arthritis, diabetes, Alzheimer's disease and various forms of cancer. Older people often take many different medications to deal with their health problems. This can make it more difficult for a health care provider to choose ARVs, because of interactions with other medications.
Some ARVs may increase the risk of diabetes, high blood pressure, or osteoporosis. This makes it harder to choose the right HIV regimen.
Older people may have more problems with thinking and remembering than younger people. These symptoms can be the same as HIV-related mental problems. Fact Sheet 505 has more information on HIV and nervous system problems.
These problems, sometimes called dementia, are less severe than they were before the use of strong ARVs. It is difficult to know what is causing mental problems in older people with HIV. Is it normal aging, or is it HIV disease? Research studies have linked both age and higher viral load (see Fact Sheet 125) to mental problems.
Rates of depression and substance use haven't been well studied in older people. However, these problems may be related to HIV disease, aging, or both. They need to be diagnosed and treated correctly.
The Bottom Line
The number of people over 50 with HIV or AIDS is growing rapidly. Between 10% and 15% of people with AIDS in the United States are over age 50.
Older people get HIV the same way as younger people. However, they may not be aware that they are at risk of HIV infection. They also may not know how to protect themselves from HIV transmission.
Older people have to deal with other health issues. These can complicate the selection of ARVs. They can also be confused with some of the side effects of ARVs.
ARVs work about as well in older people. Also, older people may be better about taking their medications than younger people.
This article was provided by AIDS InfoNet.
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