Older Women: At Risk for HIV Infection
February 6, 2015
Table of Contents
UNAIDS estimates that over 3.5 million older adults (age 50 and over) are living with HIV (HIV+) worldwide. The proportion of adults who are older and living with HIV has increased in all regions since 2007, and is highest in high-income countries.
In the US, HIV began mostly as a disease of young men. Today, however, the epidemic affects both women and men of all ages, including older women. While 45 or 50 may not seem 'old,' it is often the age currently used by organizations that keep track of health-related statistics (e.g., the US Centers for Disease Control and Prevention, or CDC).
While most new HIV infections are still in younger people, women over 50 are getting HIV at an increasing rate. In addition, many people living with HIV are living longer, healthier lives because of the success of newer HIV drugs. As a result, it is estimated that by 2015, almost half of all people in the US living with HIV will be over 50.
Older women are sometimes ignored or overlooked in discussions about HIV prevention and care. It is important that this change, and that older women, their health care providers, and their families understand how the virus can and does impact this group.
- The number of women over 45 living with HIV in the US has been steadily growing in recent years. According to the CDC, the number of women over 45 living with HIV increased 22 percent from 2006 to 2008, and an additional 26 percent from 2008 to 2011. In 2011, women over 45 represented over half of all women living with HIV (52 percent). In 2012, women over 45 represented over one third of all newly-diagnosed women in the US. It is important to consider that these reported numbers are likely smaller than the real number of women over 45 living with HIV, since many people do not get tested for or diagnosed with HIV even though they may have been HIV+ for several years.
- Despite the myth that older people do not have sex, many older women are sexually active. One study showed that close to three out of four people aged 57 to 64 had had sex in the last year, as had over half of those aged 65 to 74. Older women can actually be at greater risk for HIV infection during sex than younger women because of thinner vaginal walls and dryness that can cause tears in the vaginal area.
- Many women over 50 are thinking about dating and becoming sexually active after the end of a long-term relationship or the death of a partner. Women who have been in monogamous relationships for many years and are now becoming sexually active with new partners may not see themselves as at risk for HIV. They may feel uncomfortable discussing sexually transmitted diseases (STDs) or safer sex with their partners or health care provider, and may not know how to protect themselves.
- Many older women have gone through menopause and therefore do not think about using condoms for birth control. However, condoms can prevent the spread of STDs at any age. For more, see our article, Talking with Your Partner about Condoms.
- Older HIV+ women are more likely to be invisible and isolated, keeping their disease hidden from friends and family. They are afraid to admit they have HIV because of the stigma.
- Due to the lack of awareness of HIV in the older population (women in particular), this age group has been left out of educational prevention programs, research, and clinical trials.
- Many older women inject drugs, and are therefore at risk of getting HIV from sharing needles and other drug equipment. The CDC reports that injection drug use is the cause of about 16 percent of new HIV diagnoses in people over 50.
- Older individuals are not routinely tested for HIV. This occurs in part because health care providers often feel uncomfortable asking older patients about their sexual behaviors. It also occurs because health care providers, like the general public, are often under the misconception that older women are not sexually active. Therefore, when faced with an older patient with flu-like symptoms, many health care providers do not think to test for HIV. This means that older women are often misdiagnosed and/or not diagnosed with the virus until they have reached a more advanced stage of HIV disease.
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