Anna was a peer counselor in the HIV prevention department of our AIDS service agency for just eight months. She was much older than our other women at 62. She called herself the "Mom" of the group.

As a peer counselor, Anna was careful to ensure that older people were given prevention information. She often stated that older people do not talk about their sex lives, but were having sex, usually unprotected.

Anna had some risky behaviors in her own past, but she thought a diagnosis of HIV would never happen to her and neither did her doctor. Although she was increasingly sick, it was not until she developed TB that her HIV status was discovered. By then, it was too late. Anna died in the hospital.

Anna is not alone. There are many HIV-positive people who are over 50. In fact, in New York City the rate of HIV infection had increased to 15% in 2003 among the over 50 population. There are several reasons why older people are getting infected:

• Not knowing the risk factors for HIV infection.

• Not receiving prevention education.

• Believing that HIV only affects younger people.

• Having unprotected heterosexual or homosexual sex.

• Sharing needles.

• Being newly single. Many older people get divorced or lose their mates. While they had a partner they may have ignored HIV prevention messages.

For an older person, an HIV diagnosis can cause disbelief, denial and fear of disclosure and retaliation. Here are some tips to help cope with HIV as a senior:

• Make sure you have the right doctor. Does your current doctor have experience treating HIV? If not, you may need to find a new doctor and/or clinic where you can receive good quality HIV care from more knowledgeable providers.

• If you don't have a doctor, get one. Find a healthcare provider locally, or out of the area if you prefer. But find one who is accessible and will help you understand your treatment options.

• Get professional support. You may be afraid to disclose your HIV status to the people who normally support you. Try talking to a mental health counselor, health educator or peer counselor. These people have a great deal of knowledge to share. Some peer counselors may have had similar experiences and can help you develop good coping strategies.

• Think about how you handle stress. What is the likelihood that you will fall back on prior destructive behaviors (such as isolation, depression, substance use)? Seek support so you do not lose control and fall into a pattern that can only be detrimental to your future health.

• Don't hide. Join an HIV support group. You may make a friend who can help you through the emotional trauma.

• Get a life with HIV. Consider getting involved in volunteering or advocacy work. Making a personal contribution can make your life worthwhile.

• Get medical attention for the special needs of seniors. Menopausal and post-menopausal women may have concerns about hormone therapy and cervical cancer. Seniors may already be taking many medications. Find out about HIV drug interactions. Be aware of increased risks for heart disease and diabetes.

• Learn all you can about HIV. Educate yourself so you will understand how you got infected and basic facts about HIV and treatment options. Some resources are:

  • National AIDS Hotline: 1-800-CDC-INFO

  • Project Inform Treatment Information Hotline: 1-800-822-7422

  • New Mexico AIDS Infonet: www.aidsinfonet.org

  • National Association on HIV over Fifty: www.hivoverfifty.org

It is important to find out your HIV status to get the care and treatment you need. But since many geriatric doctors are not looking for HIV among their patients, the diagnosis often comes too late, as it did in Anna's case.

You could be Anna, or Anna could be the older woman next door or a family member. If you or someone you know could be HIV positive, no matter what their age, look into HIV testing. You have a better chance of staying well if you are diagnosed sooner rather than later and if you get good medical care. And if you are negative, you can learn what precautions you need to take to stay that way.

Marie M. Saint Cyr, M.S.W. is the executive director of Iris House Center for HIV-positive women.