HIV, AIDS and Older People

Grace was dating again. George, a close family friend she had known for a long time, was starting to stay overnight more and more often. Because she was past childbearing age, Grace didn't think about using condoms. And because she had known George for so long, she didn't think to ask him about his sexual history. So, Grace was shocked when she tested positive for HIV.

What Is HIV? What Is AIDS?

Like most people, you probably have heard a lot about HIV and AIDS. You may have thought that these diseases weren't your problem and that only younger people have to worry about them. But anyone at any age can get HIV/AIDS.

HIV (short for human immunodeficiency virus) is a virus that damages the immune system -- the system your body uses to fight off diseases. HIV infection leads to a much more serious disease called AIDS (acquired immunodeficiency syndrome). When the HIV infection gets in your body, your immune system can weaken. This puts you in danger of getting other life-threatening diseases, infections, and cancers. When that happens, you have AIDS. AIDS is the last stage of HIV infection. If you think you may have HIV, it is very important to get tested. Today there are drugs that can help your body keep the HIV in check and fight against AIDS.

What Are the Symptoms of HIV/AIDS?

Many people have no symptoms when they first become infected with HIV. It can take as little as a few weeks for minor, flu-like symptoms to show up, or more than 10 years for more serious symptoms to appear. Signs of HIV include headache, cough, diarrhea, swollen glands, lack of energy, loss of appetite and weight loss, fevers and sweats, repeated yeast infections, skin rashes, pelvic and abdominal cramps, sores in the mouth or on certain parts of the body, or short-term memory loss.

Getting Tested for HIV/AIDS It can take as long as 3 to 6 months after the infection for the virus to show up in your blood. Your health care provider can test your blood for HIV/AIDS. If you don't have a health care provider, check your local phone book for the phone number of a hospital or health center where you can get a list of test sites. Many health care providers who test for HIV also can provide counseling. In most states the tests are private, and you can choose to take the test without giving your name. You can now also test your blood at home. The "Home Access Express HIV-1 Test System" is made by the Home Access Health Corporation. You can buy it at the drug store. It is the only HIV home test system approved by the Food and Drug Administration (FDA) and legally sold in the United States. Other HIV home test systems and kits you might see on the Internet or in magazines or newspapers have not been approved by FDA and may not always give correct results.

How Do People Get HIV and AIDS?

Anyone, at any age, can get HIV and AIDS. HIV usually comes from having unprotected sex or sharing needles with an infected person, or through contact with HIV-infected blood. No matter your age, you may be at risk if:

• You are sexually active and do not use a latex or polyurethane condom. You can get HIV/AIDS from having sex with someone who has HIV. The virus passes from the infected person to his or her partner in blood, semen, and vaginal fluid. During sex, HIV can get into your body through any opening, such as a tear or cut in the lining of the vagina, vulva, penis, rectum, or mouth. Latex condoms can help prevent an infected person from transferring the HIV virus to you. (Natural condoms do not protect against HIV/AIDS as well as the latex and polyurethane types.)
• You do not know your partner's drug and sexual history. What you don't know can hurt you. Even though it may be hard to do, it's very important to ask your partner about his or her sexual history and drug use. Here are some questions to ask: Has your partner been tested for HIV/AIDS? Has he or she had a number of different sex partners? Has your partner ever had unprotected sex with someone who has shared needles? Has he or she injected drugs or shared needles with someone else? Drug users are not the only people who might share needles. For example, people with diabetes who inject insulin or draw blood to test glucose levels might share needles.
• You have had a blood transfusion or operation in a developing country at any time.
• You had a blood transfusion in the United States between 1978 and 1985.

Is HIV/AIDS Different in Older People?

A growing number of older people now have HIV/AIDS. About 19 percent of all people with HIV/AIDS in this country are age 50 and older. This is because doctors are finding HIV more often than ever before in older people, and because improved treatments are helping people with the disease live longer.

But there may even be many more cases than we know about. Why? One reason may be that doctors do not always test older people for HIV/AIDS and so may miss some cases during routine check-ups. Another may be that older people often mistake signs of HIV/AIDS for the aches and pains of normal aging, so they are less likely than younger people to get tested for the disease. Also, they may be ashamed or afraid of being tested. People age 50 and older may have the virus for years before being tested. By the time they are diagnosed with HIV/AIDS, the virus may be in the late stages.

The number of HIV/AIDS cases among older people is growing every year because:

• Older Americans know less about HIV/AIDS than younger people. They do not always know how it spreads or the importance of using condoms, not sharing needles, getting tested for HIV, and talking about it with their doctor.
• Health care workers and educators often do not talk with middle-age and older people about HIV/AIDS prevention.
• Older people are less likely than younger people to talk about their sex lives or drug use with their doctors.
• Doctors may not ask older patients about their sex lives or drug use, or talk to them about risky behaviors.

Facts About HIV/AIDS You may have read or heard things that are not true about how you get HIV/AIDS. Here are the FACTS: You cannot get HIV through casual contact such as shaking hands or hugging a person with HIV/AIDS. You cannot get HIV from using a public telephone, drinking fountain, restroom, swimming pool, Jacuzzi, or hot tub. You cannot get HIV from sharing a drink. You cannot get HIV from being coughed or sneezed on by a person with HIV/AIDS. You cannot get HIV from giving blood. You cannot get HIV from a mosquito bite.

Anyone facing a serious disease like HIV/AIDS may become very depressed. This is a special problem for older people, who may have no strong network of friends or family who can help. At the same time, they also may be coping with other diseases common to aging such as high blood pressure, diabetes, or heart problems. As the HIV/AIDS gets worse, many will need help getting around and caring for themselves. Older people with HIV/AIDS need support and understanding from their doctors, family, and friends.

HIV/AIDS can affect older people in yet another way. Many younger people who are infected turn to their parents and grandparents for financial support and nursing care. Older people who are not themselves infected by the virus may find they have to care for their own children with HIV/AIDS and then sometimes for their orphaned or HIV-infected grandchildren. Taking care of others can be mentally, physically, and financially draining. This is especially true for older caregivers. The problem becomes even worse when older caregivers have AIDS or other serious health problems. Remember, it is important to get tested for HIV/AIDS early. Early treatment increases the chances of living longer.

HIV/AIDS in People of Color and Women

The number of HIV/AIDS cases is rising in people of color across the country. About half of all people with HIV/AIDS are African American or Hispanic.

The number of cases of HIV/AIDS for women has also been growing over the past few years. The rise in the number of cases in women of color age 50 and older has been especially steep. Most got the virus from sex with infected partners. Many others got HIV through shared needles. Because women may live longer than men, and because of the rising divorce rate, many widowed, divorced, and separated women are dating these days. Like older men, many older women may be at risk because they do not know how HIV/AIDS is spread. Women who no longer worry about getting pregnant may be less likely to use a condom and to practice safe sex. Also, vaginal dryness and thinning often occurs as women age; when that happens, sexual activity can lead to small cuts and tears that raise the risk for HIV/AIDS.

Treatment and Prevention

There is no cure for HIV/AIDS. But if you become infected, there are drugs that help keep the HIV virus in check and slow the spread of HIV in the body. Doctors are now using a combination of drugs called HAART (highly active antiretroviral therapy) to treat HIV/AIDS. Although it is not a cure, HAART is greatly reducing the number of deaths from AIDS in this country.

Prevention. Remember, there are things you can do to keep from getting HIV/AIDS. Practice the steps below to lower your risk:

• If you are having sex, make sure your partner has been tested and is free of HIV.
• Use male or female condoms (latex or polyurethane) during sexual intercourse.
• Do not share needles or any other equipment used to inject drugs.
• Get tested if you or your partner had a blood transfusion between 1978 and 1985.
• Get tested if you or your partner has had an operation or blood transfusion in a developing country at any time.

Resources

Health agencies in most cities offer HIV testing. The following national organizations have information about HIV/AIDS.

Centers for Disease Control and Prevention (CDC)
National AIDS Hotline
1-800-342-AIDS
(operates 24 hours a day, 7 days a week)
1-800-344-7432 for Spanish
1-800-243-7889 (TTY)
www.cdc.gov

CDC National Prevention Information Network
P. O. Box 6003
Rockville, MD 20849-6003
1-800-458-5231
1-800-243-7012 (TTY)
www.cdcnpin.org/scripts/index.asp

National Institute of Allergy and Infectious Diseases (NIAID)
Office of Communications and Public Liaison
6610 Rockledge Drive, MSC 6612
Bethesda, MD 20892-6612
301-496-5717
www.niaid.nih.gov

AIDSinfo
P.O. Box 6303
Rockville, MD 20849-6303
1-800-HIV-0440 (1-800-448-0440)
Monday to Friday, 12:00 p.m. to 5:00 p.m. Eastern Time
1-888-480-3739 (TTY/TDD)
www.aidsinfo.nih.gov

National Association on HIV Over Fifty
23 Miner Street
Boston, MA 02215-3318
www.hivoverfifty.org

Senior Action in a Gay Environment (SAGE)
305 7th Avenue
16th Floor
New York, NY 10001
212-741-2247
www.sageusa.org

For more information on health and aging, contact:

National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225
1-800-222-4225 (TTY)
E-mail: niaic@jbs1.com

To order publications (in English or Spanish) online, visit www.niapublications.org.

Visit NIHSeniorHealth.gov (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website features popular health topics for older adults. It is simple to use, has large type, and a 'talking' function that reads text aloud.