January 8, 2010
Medicare has extended coverage to include HIV testing, a move that advocates say may boost testing among the program's beneficiaries and potentially other groups.
"When Medicare covers something, it's also not just a signal to the population that this is something that's important and needs to be done, but it often becomes a standard that private insurance follows," said Judith Stein, executive director of the Mansfield, Conn.-based Center for Medicare Advocacy.
Those 50 and older accounted for about one-quarter of HIV-infected adults in 2007, and the proportion may rise to 50 percent by 2015. The older HIV-positive population consists primarily of those who contracted the disease when young and are living longer with the help of effective HIV treatments. In addition, people are contracting HIV or being diagnosed in their later years.
"HIV was very much a disease of young individuals, particularly those who are homosexual or intravenous drug abusers, and as a geriatrician, it was a problem that we very, very rarely saw," said Dr. George Kuchel, director of the University of Connecticut Center on Aging. "But that has changed a great deal."
Figures from the federal Centers for Medicare & Medicaid Services indicate that 53 percent of people ages 65 to 74, as well as 26 percent of those 75 to 85, are sexually active. The statistics contradict the stereotype of older adults as not sexually active and therefore protected from one of the common routes of HIV transmission.
Federal guidelines suggest broad screening for those ages 13-64, but not for older adults. According to 2009 Kaiser Family Foundation statistics, the incidence of HIV testing is generally lower among older adults: 16 percent of those 65 and older have ever tested, compared to 61 percent of those 30 to 49.