World AIDS Day 2016 – Aging & HIV/AIDS

In recognition of World AIDS Day today, December 1st, we at the COAPS Institute are highlighting the importance of addressing HIV/AIDS in the older adult population.  We begin with some basic information and then focus on the issue of aging and HIV/AIDS.  Resources are included if you’d like to learn more!

The Basics

HIV stands for Human Immunodeficiency Virus.  HIV can lead to Acquired Immunodeficiency Syndrome (AIDS) if it is left untreated.  HIV is transmitted through certain body fluids.  It is important to note that HIV is NOT transmitted by air, water, saliva, sweat, tears, insects, pets or by sharing toilets, food or drinks.  

Although the scientific community is earnestly working towards effective treatment, there is not yet a cure for HIV/AIDS.  Medical advancements have come a long way since the discovery of HIV/AIDS in 1981 and with proper medical care, HIV can be controlled.  Antiretroviral Therapy (ART) is the medicine used to treat HIV.  If taken the right way, every day, ART can dramatically prolong the lives of many people infected with HIV, keep them healthy, and greatly lower their chance of infecting others.

HIV/AIDS in the Older Adult Population

The following facts from the Centers for Disease Control & Prevention (CDC) highlight the importance of addressing HIV/AIDS in the older adult population.

  1. People aged 55 and older accounted for 26% of all Americans living with diagnosed or undiagnosed HIV infection in 2013.
  2. People aged 50 and older have the same HIV risk factors as younger people, but may be less aware of their HIV risk factors.
  3. Older Americans are more likely to be diagnosed with HIV infection later in the course of their disease.

There are three critical areas of need that COAPS and other aging providers and advocates should be aware of: screening, education and stigma. 

  1. Education Health literacy, the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions, is critical to knowing one’s risk and preventing disease.  Many older adults lack knowledge about HIV and how to prevent contracting it. Older adults also face some unique issues.  One such issue is dating after a divorce or after losing a partner; in these instances, older adults may not be aware of their risks for HIV or believe that HIV is not a relevant issue. Thus, they may be less likely to protect themselves.  Another issue is women who no longer worry about becoming pregnant may be less likely to use a condom and to practice safer sex.  Additionally, age-related thinning and dryness of vaginal tissue may raise older women’s risk for HIV infection.  There is a wealth of information available online that older adults can access to gain more knowledge and improve their health literacy. 
  2. Screening Much like addressing mental illness or substance use in later life, many providers may not always test older adults for HIV because they do not see it as a primary concern.  Although older adults visit their doctors more frequently than younger age groups, older adults are less likely to discuss their sexual habits or drug use with their doctors.  In addition, doctors are less likely to ask their older patients about these issues. This is a problem because we know that if ART is taken right away, a person’s health and quality of life is greatly improved and the risk of transmission is reduced.  Older adults can serve as their own advocates by requesting routine HIV screening through their primary care provider.  There are also HIV testing sites available across the county; use the testing site finder to locate the site nearest you!  It is important to note that Medicare Part B (Medical Insurance) covers HIV screenings once every 12 months. 
  3. Stigma is a particular concern among older people because they may already face isolation due to illness or loss of family and friends.  Stigma negatively affects people’s quality of life, self-image, and behaviors and may prevent them from seeking HIV care and disclosing their HIV status.  Combating HIV/AIDS stigma involves the same principles of defeating other types of stigma.  It includes: knowing the facts about HIV/AIDS; being aware of one’s own attitudes and behavior; choosing your words carefully, not adding to stigma by using derogatory language; educating others about HIV/AIDS; focusing on the positive, such as listening to the inspirational stories of persons with the disease; and including everyone in discussions, not making HIV/AIDS an issue that needs to be hidden. It is important for COAPS and others working with older adults to acknowledge that stigma is a significant barrier to treatment that needs to be addressed. 

For more information, check out these resources!

Centers for Disease Control & Prevention (CDC)

National Institutes of Health (NIH)

The Body: The Complete HIV/AIDS Resource