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More Seniors Living With HIV
  (Webmd, A growing number of older Americans are living with HIV and AIDS, but few may be receiving advice on how to avoid spreading the disease, experts told lawmakers last week.
Infection rates aren't increasing in either younger or older people, health officials say. But the widespread use of antiretroviral drugs in patients in the U.S. has greatly extended the lives of AIDS patients and caused many more to live into later years. Today in the U.S., 28 percent of those living with HIV/AIDS are over the age of 50, and by 2015 that will increase to 50 percent, said Sen. Gordon H. Smith (R-Ore.)
Figures from 32 states show that the number of persons over 50 with HIV or AIDS went from 40,000 in 2000 to more than 67,000 in 2003, according to the Centers for Disease Control and Prevention. Older blacks are 10-15 times more likely than their white counterparts to be infected.
Unique Challenges
The agency remains worried that this growing segment of the population of HIV/AIDS older adults could provide a new reservoir for the spread of HIV.
"One of the challenges in people 50 and older is the mistaken belief that they're not at risk," Robert S. Jannsen, MD, director of CDC's division of HIV/AIDS prevention, told members of the Senate Committee on Aging.
Jannsen warned that older patients, raised before the AIDS emergence of the 1980s that made "safe sex" a buzzword among youth, are less likely to see the importance of using condoms. The fact that pregnancy is not a concern for most women over 50 may also make them less likely to think of condom use, he said.
Stereotypes and lack of awareness about the disease is another challenge in preventing the spread of the disease, added Smith.
Many doctors may also be reluctant to think of their older patients as sexually active. Studies suggest that only 30 percent-40 percent of younger patients are asked by their doctors about sexual history or practices, a rate that is almost surely lower for patients over 50, Jannsen said.
As the numbers of seniors living with HIV continues to grow, so too will the demand for services, they noted.
Jeanine Reilly, executive director for Broadway House for Continuing Care in Newark, N.J., said the average age of patients at the long-term care facility for AIDS sufferers has increased from 31 to 44 in the last four years.
"This is a much bigger danger than most people are aware of," she told WebMD. Reilly also complained that Viagra and related drugs have encouraged older people to have more sex without a corresponding increase in safe sex education.
"Baby boomers are not relinquishing their sexuality simply because they are getting older," she said. "The message about the threat of HIV/AIDS is not there."
Smith, who leads the aging committee, said he was likely to add provisions for improved AIDS education for older persons when Congress considers the reauthorization of the Ryan White AIDS Care Act later this year.
Sources: Robert S. Jannsen, MD, director, division of HIV/AIDS, CDC. Jeanine Reilly, executive director, Broadway House for Continuing Care, Newark, N.J. Sen. Gordon Smith (R-Ore.).
Seniors & HIV Awareness
Oct. 14, 2004
Older women, revered for their bedroom prowess in movies like "The Graduate" and "American Pie," may not be any wiser when it comes to knowing about HIV transmission, according to a survey in a recent issue of the Journal of the American Geriatrics Society.
The researchers conducting face-to-face interviews with more than 500 women aged 50 and older from June 2001 and July 2002. Women were asked nine questions to assess their knowledge of HIV transmission and prevention. Topics included heterosexual intercourse, kissing, oral sex, abstinence, condoms, spermicides, diaphragms, vasectomies, and monogamy.
Of the nine questions about HIV transmission, 65 percent answered four or fewer questions correctly. None answered them all correctly.
For example:
- 84 percent correctly said that unprotected heterosexual sex was a moderate- to high-risk activity for HIV transmission.
- 63 percent incorrectly identified kissing as a mode of HIV transmission.
- 76 percent overestimated oral sex as a mode of HIV transmission.
- Only 13 percent identified condoms as effective in preventing HIV transmission, while 18 percent said they were not effective at all.
- 44 percent of the women incorrectly said abstinence was "not at all" or "somewhat effective" in preventing HIV transmission.
According to Planned Parenthood Federation of America, condoms can protect both partners from STDs including HIV during vaginal and anal sex.
HIV and the Elderly: A Catch-22?
"The misconception is that older people don't have sex anymore and that they are really not engaging in risky activity," says lead researcher Lisa Bernstein, MD, an assistant professor of medicine on the Emory University School of Medicine in Atlanta, in a news release. "As part of older women being at risk for HIV, much of it is based on how much they know about HIV. Unfortunately, this population has not been targeted with HIV prevention messages because they aren't considered to be at risk — yet their risk is probably rooted in their low knowledge."
When asked to name how they got HIV transmission information, 85 percent of the women said it came from television, 54 percent said it came from their friends, and 51 percent cited newspapers. But even more alarming is that only 38 percent said they had ever received information on HIV transmission from a health-care professional.
As many as 10 percent of AIDS cases in adult women occur in those aged 50 and older. Women in this age group are mainly infected as a result of sexual intercourse.
"The important thing to realize is that these patients are still sexually active. The problem is that they don't realize that they're at risk for this life-threatening disease," says Bernstein.
SOURCES: Henderson, S. Journal of the American Geriatrics Society, September 2004; vol 52: pp 1549-1553. News release, American Geriatrics Society.
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