Gary Pratt et.al reviewed HIV in older people last year and documented that there were several reasons why older people were at risk.
1. The few HIV prevention campaigns that do exist do not target the elderly.
2. Older people may not consider themselves at risk of HIV infection.
3. Health care providers may not consider the diagnosis in older patients and therefore may not undertake HIV testing or may attribute symptoms of HIV to ‘normal ageing’.
4. Despite the stereotypes, many older people lead sexually active lives. Studies of sexual activity in people aged over 50 showed that 81.5% were involved in one or more sexual relationships including sex with prostitutes,and a national US survey suggested that only a small minority of people over 70 consistently used condoms. Older women may be especially at risk because age-related vaginal thinning and dryness can cause tears in the vaginal wall.
5. The increase in foreign travel makes access to countries with thriving sex industries easier.
6. The introduction and usage of potency drugs has extended the sex lives of many elderly males.
7. Injection drug usage, despite our misconceptions, is a contributor to HIV transmission in older people. In the USA, injection drug use accounts for more than 16% of AIDS cases in those aged 50 or over.
8. The stigma of HIV may be perceived to be greater in the elderly population leading them to hide their diagnosis or avoid testing.
The paper is a very good review in Age and Aging. My colleague – Ruth Smith present some important findings at the joint conference of the British HIV Association (BHIVA) and the British Association for Sexual Health and HIV (BASHH) last week. In the United Kingdom, one in twelve HIV diagnoses are of a person over the age of 50. Whilst rates of late diagnosis are high in older adults, just under half of these diagnoses are thought to be of an infection that was acquired when the person was over the age of 50.
