I’m Over Fifty. Do I Need to Worry About HIV?

Hi, I’m [PRESENTER NAME], a [PRESENTER ROLE]. Welcome to “I’m Over Fifty. Do I Have to Worry About HIV?” This video will explain why older people need to be just as careful to avoid contracting HIV as younger people do.
Is HIV Just a Problem for Young People?
People often assume that older adults don’t need to worry about HIV. Many people associate HIV and AIDS primarily with younger sexually active people and incorrectly assume that HIV positive people are members of various groups. Few people realize that in 2005, 15% of new HIV/AIDS diagnoses in America were in people aged 50 and older.  That means that almost one in six new HIV/AIDS diagnoses were in people age 50 and older. Moreover, because people with HIV/AIDS are now living much longer, in 2005, 24% of people living with HIV/AIDS in America were age 50 and older.  
Older People Have Similar Risk Factors to Young People
People in the developed world often wrongly think that HIV is a disease of young people, particularly of gay men, minority communities and injection drug users. In reality, older people have many of the same risk factors as younger people. The United States Centers for Disease Control and Prevention notes that like younger people, older people have sex and inject drug, which can put them at risk for HIV infection. The CDC also notes that “HIV transmission through injection drug use accounts for more than 16% of AIDS cases among persons aged 50 and older.”  
Additional Risks Faced by Older People
Since post-menopausal women no longer need to worry about preventing unwanted pregnancies, they do not use contraception and may choose not to use condoms as a result. It is important to remember that older women are also at risk for contracting sexually transmitted diseases, including HIV. In reality, they need to use condoms, even if they are no longer able to become pregnant. As women age, the vaginal wall grows thinner and vaginal lubrication is reduced. This can lead to tears in the vagina that increase the risk of contracting HIV.   

Many older people may be less knowledgeable about HIV and wrongly think they are not at risk for HIV. This may increase the risk that they will fail to use condoms and that they will not get tested for HIV.    

If people have multiple sexual partners, the risk of HIV transmission may be increased. A person is most infectious and most like to transmit HIV in the period immediately after they are initially infected.

The development of medications for erectile dysfunction such as Viagra has meant that many older men who previously were unable to have sex are now able to be sexually active again. At the same time, because men die younger on average than women, there are more women than men in their sixties, seventies, and eighties. This means that the relatively smaller number of sexually active older men have the opportunity to have multiple sexual partners. The combination of a smaller number of older men who are once again capable of sex and the ability to have unprotected sex with a potentially large number of older women who may be longing for companionship increases the risk that HIV will be transmitted. 
Health Professionals May Fail to Diagnose HIV/AIDS in Older People
Older people may be less likely to receive education on HIV prevention and testing. The United States Centers for Disease Control and Prevention (CDC) notes that “Health care professionals may underestimate their older patients’ risk for HIV/AIDS and thus may miss opportunities to deliver prevention messages, offer HIV testing, or make an early diagnosis that could help their patients get early care.”  The CDC adds that “Physicians may miss a diagnosis of AIDS because some symptoms can mimic those of normal aging, for example, fatigue, weight loss, and mental confusion.” Older people can assist the healthcare professional and help prevent these kinds of oversights by getting regular medical checkups, informing their doctors of any risk factors they may have for HIV, and asking to be tested for HIV.
HIV Stigma Among Older People
The CDC adds that “The stigma of HIV/AIDS may be more severe among older persons, leading them to hide their diagnosis from family and friends. Failure to disclose HIV infection may limit or preclude potential emotional and practical support.”  Inadequate emotional support may increase their risk for clinical depression as they confront the challenges of HIV and AIDS. It may also make it harder for older people to reach out to friends and family to seek help for practical needs like transportation to doctor appointments, supplemental care, and other needs.

No matter who you are, you are a valuable individual. If you are a person over 50, realize that you need to be just as careful about HIV as younger people. If you choose to be sexually active, get tested for HIV to know your status, insist that your partners do the same, and use safer sex techniques like condoms to reduce your risk of contracting HIV and other sexually transmitted diseases. This is [PRESENTER NAME].

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Script by Becky Kuhn, M.D. of Global Lifeworks and Eric Krock of AIDSvideos.org.

This script was reviewed for accuracy and approved by Becky Kuhn, M.D. on July 30, 2011.