Older People Face Greater HIV Infection Risks: Study

Physicians are failing to diagnose HIV infection among older patients, even as many people over age 50 enjoy extended sex lives thanks to erectile dysfunction drugs, the World Health Organization reported Tuesday. Sexually active people age 50 and up are less likely to have protected sex than younger persons, and they are increasingly contracting HIV, WHO said.

"HIV prevalence and incidence in the over-50-year-olds seem surprisingly high and the risk factors are totally unexplored," the report's authors said. "These individuals have a shorter time from diagnosis to the onset of AIDS, reflecting both age-related faster progression to AIDS and doctors' failure to consider HIV as a diagnosis."

Sex is the most likely transmission mode among older patients, at least in part due to their uptake of impotence drugs, WHO said. Older women appear to have a higher risk of infection during condomless sex because of the age-related thinning of the vagina's lubricating mucous membrane.

"Since 1998, erectile dysfunction drugs have been extending the sex life of many older individuals and, at the same time, may be extending the HIV epidemic into older age groups," WHO said. "While erectile dysfunction is common and erectile dysfunction drugs are widely available in developing countries, no study has been done of their possible impact on the HIV epidemic, although their use in industrialized countries has been associated with risky safety practices."

HIV patients over age 50 account for about 8 percent of new HIV diagnoses in Europe and 11 percent in the United States. Risk factors among older patients' in developing countries have not been studied, nor are prevalence data available, but WHO said similar infection trends are likely occurring there.

The study, "The Unexplored Story of HIV and Ageing," was published in the Bulletin of the World Health Organization (2009;87(3):161-244).

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