These widows and divorcees are often re-entering the dating scene after years of marriage, which insulated them from worries about AIDS and other sexually transmitted diseases. Since they are post-menopausal, they often think they do not need to insist that their partner use a condom. They have little inclination to quiz a potential partner about his past sexual encounters (or even his current ones) or about drug use.
NAHOF volunteers and other community based AIDS outreach groups are trying to pierce this fog of ignorance and denial. At conferences, workshops, and senior community centers, educators are alerting older adults to their risk, giving them the facts about how HIV is transmitted, teaching them how to negotiate with partners to practice safe sex and how to ask questions of their health providers, urging them to get tested, and handing out free condoms.
AIDS Strikes Seniors Hard
In an article on HIV infection in elderly patients published in the Southern Medical Journal in 2001, Adeel A. Butt, M.D., and other researchers find that patients who are older than 60 years at the time of diagnosis of HIV infection have a shorter survival than younger patients. This may be due in part to the fact that seniors who are infected with HIV tend to be diagnosed later than younger individuals. It is likely that it is also due to the natural decrease in strength of the immune system in people as they age.
A number of conditions common in the elderly may be intensified by their HIV or AIDS status. Feelings of isolation, depression, and fatalism may be exaggerated. They may withdraw from their families in shame, or their families may desert them. If they are living on a limited income, they may find it difficult to afford the medical and social assistance they need.
Other medications they are taking, like cholesterol-lowering drugs, may interact with the drugs they take to control HIV. They may find it difficult to take the large number of drugs necessary to control HIV, or to maintain the precise schedule of dosage they require. AIDS-related intestinal disturbances may make it difficult for the elderly to stay properly nourished. If they live in a retirement or nursing home, they may be exposed constantly to opportunistic respiratory and gastroenteric infections. Tuberculosis is often associated with outbreaks in nursing homes and hospitals, and is particularly dangerous to immune-suppressed elderly residents.
A Grim Trend
AIDS is increasingly not only a disease of heterosexual contact, but one of minorities and women. FirstGov for Seniors, an informational web site maintained by the Social Security Administration (www.seniors.gov), has compiled the following statistics:
52% of people 50 and over with AIDS are African American or Hispanic.
49% of men 50 and over with AIDS are African American or Hispanic.
70% of women 50 and over with AIDS are African American or Hispanic.
Over the last five years, the number of new AIDS cases in women 50 and older rose by 40%.
Jane Fowler calls it the graying of HIV. She says, Older people with HIV suffer two stigmas. One is the stigma of living with a disease that is transmitted sexually or through drug abuse. The second is the stigma of being older.
To alert seniors and reduce the grim statistics, we ll need education and intervention efforts from public health programs, from healthcare professionals, from family members and friends, and from activist seniors like Jane Fowler. Because no one wants his or her 62-year-old grandmother to get AIDS.
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