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Women over 50 in dark over HIV
 
 
  By HELENA OLIVIERO
The Atlanta Journal-Constitution
Published on: 11/10/04
 
As throngs of older women divorce and re-enter the dating scene, a new Emory University study has found women older than 50 are extremely naive about the spread of HIV.
 
About half of the 514 women surveyed believed vasectomies provided some protection against HIV. Half of the women also thought diaphragms also prevented the spread of the deadly disease.
 
They don't.
 
On the flip side, only 13 percent of the women knew that condoms were very effective in preventing the spread of the disease. None of the 514 women surveyed answered all of the nine questions correctly.
 
Married and raising kids during the emergence of HIV/AIDS, many older women tuned out the "safe sex" message, according to Dr. Lisa Bernstein, an assistant professor of medicine at Emory University's School of Medicine, who led the study.
 
"It was a little scary," said Bernstein about the survey results. "These women do not realize they are at risk. And there is a major knowledge deficit."
 
About 11 percent of AIDS cases in Georgia involve adults 50 and older, according to the Georgia Division of Public Health. A recent Centers for Disease Control and Prevention study — based on HIV surveillance data from 1994 to 2000 — suggests HIV diagnosis rates among older women may have stabilized or even fallen.
 
Still, as myths about the disease and who is at risk are rampant, organizations tracking these trends say older people must be more vigilant to remain HIV-free.
 
The greatest hope in controlling the disease — a vaccine — appears years or decades away. Today's main preventive tool is education — chiefly the "ABC" approach, recommending abstinence, being faithful and using condoms.
 
Bernstein, also an internist at Grady Memorial Hospital, got the idea for the study after asking a female patient in her 50s in a new relationship if she was using protection.
 
"She just laughed and said, 'I can't get pregnant,' " said Bernstein. "Older women think I am insane for asking the question."
 
Bernstein said she wanted to find out whether other women beyond their childbearing years think about protection.
 
Observers say many older women paid no more attention to messages about HIV than a young person today might listen to the details of a prescription drug plan for seniors.
 
Kim Anderson, executive director of AID Atlanta, is encouraged, however, by a recent interest in outreach programs at senior centers — about five hosted programs in the past year.
 
"As the population quietly admits that because of Viagra and other reasons, they are sexually active, senior [centers] are asking us to come out and talk to them about it," said Anderson.
 
Just a few years ago, it was rare for the AID Atlanta hotline to receive calls from the elderly asking questions about condoms, HIV and testing. Nowadays, about 13 older adults call each month to inquire about the disease.
 
"How do you have that discussion if you've never had it before?" said Loreen Maiorino Krug, volunteer services coordinator for AID Atlanta. "We teach women it's OK to carry condoms and it's OK to question what a gentleman did before this relationship."
 
The women who were surveyed were randomly selected from a group of patients at Grady Memorial Hospital. Women who had at least some college education were twice as likely to answer at least five of the nine questions correctly. Still, among the more educated women, 40 percent of the women got at least half of the questions wrong.
 
A recent CDC analysis of 25 HIV-reporting states found people born before 1950 accounted for an estimated 11 percent of the newly diagnosed HIV cases in 2000. The same study — which did not include Georgia — estimated about 15 percent of the newly diagnosed HIV cases in 1994 involved people in this age group.
 
But it's unclear how many older women in Georgia are infected with HIV. Georgia state health officials just adopted a new tracking system this year, and no results are yet available.
 
Georgia was the last state in the country to launch an HIV reporting system, delayed in part because of privacy concerns. And although public health officials have long required doctors to report cases of AIDS, officials believe HIV information is needed to better measure trends.
 
Grady is located in a county classified as a high-incidence area for HIV, according to the Emory study. In 2001, Fulton County had a cumulative AIDS incidence of 1,293 cases per 100,000 residents. In Georgia, about 13 percent of AIDS cases in adult women have occurred in those age 50 and older. Older people typically get diagnosed with HIV late in the course of infection (it's not unusual for them to already have full-blown AIDS at the time of diagnosis) because they are not considered at risk for the disease, according to Bernstein. More than half of the women surveyed never discussed HIV transmission with their health-care provider, according to the study recently published in the Journal of American Geriatrics Society. The women were far more likely to get information from TV or friends.
 
"Women might think he looks clean or he is a nice guy," said Bernstein. "What we need to do is bridge the knowledge gap. That's the first step, and then women can take steps to protect themselves."
 
Test your knowledge about women and HIV:
 
1. When a man and woman have sex, what do you think the risk is of getting HIV or AIDS?
 
Answer: moderate, high
 
2. When a man and woman kiss, what do you think the risk is of getting the AIDS virus?
 
Answer: none
 
3. When a man and woman have oral sex, what do you think the risk is of getting the AIDS virus?
 
Answer: low
 
4. How effective do you think not having sex at all is at preventing someone from getting HIV or AIDS?
 
Answer: very
 
5. How effective do you think using a condom during sex is at preventing someone from getting HIV or AIDS?
 
Answer: very
 
6. How effective do you think using a spermicidal jelly, foam, or cream (without a condom) is at preventing someone from getting HIV or AIDS?
 
Answer: not at all
 
7. How effective do you think a using a diaphragm during sex is at preventing someone from getting HIV or AIDS?
 
Answer: not at all
 
8. How effective do you think a man having a vasectomy (being sterilized) is at preventing someone from getting HIV or AIDS?
 
Answer: not at all
 
9. How effective do you think having sex with one single partner who does not have the AIDS virus is at preventing someone from getting HIV or AIDS?
 
Answer: somewhat, very
 
Source: a study according to "Older Women and HIV: How much do they Know and Where are they getting their Information?" published recently in Journal of American Geriatrics Society
 
 
 
 
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