Date: July 1st, 2010
When the AIDS epidemic first shook the nation in the 1980s, no one with the virus was expected to live long—let alone reach old age. But thanks to the discovery of effective drug therapies, most people with the disease can now look forward to living well into their senior years. Add to that the fact that older Americans are becoming newly infected at an alarming rate, and HIV/AIDS is clearly no longer a problem for the young.
Today, 35% of people living with HIV are age 50 and older—the fastest-growing segment of the United States population with HIV/AIDS. By 2015, experts estimate that almost half of HIV-positive Americans will be over the age of 50.
For those seniors living with the disease, many are facing accelerated aging—and resulting age-related disease—because of the virus and the medications used to treat it. For those seniors at risk of contracting the virus, most don’t even know it.Seniors at Risk
“Age won’t protect you from AIDS” reads a poster from the New York Health Department, addressing the fact that seniors are woefully uneducated about the disease and their risk. While blood transfusion was once the major transmission mode—heterosexual contact and IV drug use are now the main causes of new infection in seniors. Yet seniors don’t know much about HIV/AIDS because it didn’t seem to be a problem that their generation needed to worry about.
Thanks in part to sexual performance drugs, seniors are staying sexually active longer, yet they may not perceive themselves to be at risk and are under-educated about safe-sex practices. Women may forgo protection since they no longer need to worry about birth control, while at the same time changes in their bodies—like vaginal dryness from hormone changes—are actually putting them at higher risk of contracting HIV.
To make matters worse, doctors often fail to screen for HIV in seniors. In fact, the current Centers for Disease Control guidelines recommend routine testing for all patients ages 13 to 64. So doctors are not likely to test for the disease and may not even discuss it with their older patients. They may be uncomfortable discussing intimate relationships…or figure that they don’t need to. Patients may in turn hesitate to share private details, and they both end up avoiding the topic.
Older adults who are infected and experiencing symptoms of HIV or AIDS may not be properly diagnosed because they, or their physician, may mistake the signs of the disease for the aches and pains of “normal aging.” HIV symptoms that may be mistakenly confused with what people believe to be “normal aging” include lack of energy, loss of appetite, weight loss, and short-term memory loss. This mistake can significantly delay critical medical attention that can make an enormous difference in quality of life and life expectancy.
Living with the Disease
While it is still a devastating and serious disease, thanks to treatment advances the outlook for individuals with HIV and AIDS is improving. Drug cocktails help keep the disease under control and allow people to live longer than ever thought possible. Because it has become a manageable chronic disease, we are now seeing the first generation of seniors to age with the virus. This means that many seniors know very little about dealing with health and treatment plans that are complicated by aging.
At the same time we are seeing a growth in new infections, many seniors living with the disease were diagnosed decades ago when the disease was considered a certain death sentence. Many watched their friends and loved ones die from the disease and never expected to deal with the side-effects of their medications or the diseases of aging. They are now finding that the virus—and the medications used to fight it—may hasten the onset of diseases such as diabetes, heart disease, cognitive decline, cancer, and osteoporosis.
The disease and its treatments can significantly weaken immune systems (the immune system also weakens with age) so that individuals with HIV/AIDS are struck younger and harder by chronic diseases of aging. Their weakened immune systems also become less effective at fighting off the virus. They may be living longer than they expected, but they are getting older faster as they face accelerated aging.
Facing the New Face of HIV/AIDS
As we learn more about the rise in seniors, our challenge becomes recognizing and addressing the new face of HIV/AIDS. Doctors and health care professionals need to learn that seniors are an at-risk population that should be tested for and taught about the disease. They should be encouraged to talk to their older patients about their lifestyles and risk factors, and help them understand that they aren’t safe from the disease. This can no longer be a hidden problem.
Health care professionals also need to better understand the health challenges that older patients living with HIV/AIDS are dealing with. More research into the impact of the virus and medications on the immune system and disease may also bring better treatment options and outcomes to older patients.