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Bear60
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The Greying of HIV
      #203240 - 08/11/06 02:32 PM

HIV Goes Grey

by Laura Whitehorn



July 26, 2006—Mind your elders: HIV’s fastest-growing segment is about to get some long overdue attention. Data from the first comprehensive study of adults over 50 with HIV will “shout it from the rooftops: Do not ignore these people,” says lead researcher Stephen Karpiak, PhD, of the AIDS Community Research Initiative of America (ACRIA).

The study’s specific findings have been embargoed until July 31 (they’ll also be announced next month at Toronto's International AIDS Conference), but POZ got a sneak preview. The 50-page study shows in extraordinary detail that while the number of older people with HIV is ballooning, their social, medical and psychological problems are being grossly neglected.

And this is no minor slight: In New York City, where rates of HIV are among the highest in the country, nearly one of every three positive persons may be over 50. The AIDS Service Center NYC reports that its over-50 client base has grown by 160% since 2001. Nationwide, the Centers for Disease Control (CDC) say that the number of HIV cases in adults over 50 increased more than 50% between 2000 and 2003.

What drives the spurt? It’s not the Viagra boom, despite speculation that drugs meant to jump-start aging sex drives have also sparked widespread unsafe sex among seniors. The truth, says Karpiak, is less titillating: “Positive people are simply living longer due to the success of HAART.”

Behind the numbers hangs a tattered treatment chart. According to activist Jane Fowler, 71, who has been positive since 1991 and giving speeches on HIV and aging since 1995, no one seems to have been listening. “I don’t see that it gets any more attention than it ever has,” she says. “There are still no answers to our questions about how HIV affects us as we age.”

Fowler and her peers feel forgotten. Chardelle Lassiter, a Brooklynite who has been positive for 18 years and just turned 60, says she’s tired of being “the odd woman out” in a community where the phrase “people with HIV” doesn’t seem to include those of a certain age.

Even in support groups, she says, “I feel invisible because the focus is on younger gay men and IV-drug users." She adds, “We share issues, but there are differences.” Such as the advice Lassiter got from her gynecologist to have a hysterectomy because "You don’t need those ovaries anymore.”

Karpiak calls for a scientific assault on the persistent mysteries of HIV and aging. For instance, “No one has looked at how aging affects antiviral meds,” he says, explaining that as you grow older, the ability of your gut and liver to absorb meds changes. Not to mention drug interactions, as older people acquire more pill bottles as they acquire more symptoms.

Also, adds Karpiak, doctors need to shed their own prejudices about older patients: Depression (already common among those with HIV) worsens with age, yet Karpiak says many physicians consider it a fact of life for older patients—instead of treating it.

POZ surveyed six large New York-area AIDS service organizations (ASOs) and found some senior resources at four of them. But only a small fraction of the city’s over-50 population uses them, perhaps because they don’t address the demographic’s social challenges. Many older people live alone, have little family contact and fewer opportunities for peer interaction. “The answer,” Karpiak says, “isn’t the ASOs; it’s the larger community, like churches, for instance. There are 365 senior centers in New York City, and they should be meeting the needs of this group.”

After ACRIA shouts this message from the rooftops, what’s next? Says Karpiak, “We have to get rid of stigma,” which prevents positive seniors from talking about their HIV and getting the same care their negative counterparts do. “For positive people over 50, it’s like the early days of AIDS,” Karpiak says. “Remember? Silence equals death.”



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