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The Graying of the AIDS Epidemic

By Liza Berger, Staff Writer

(Page 1 of 3)

People are aging with HIV. The introduction of highly active antiretroviral therapy (HAART) more than a decade ago has allowed people to live with the illness that was once almost certainly fatal. But the problems associated with growing older have introduced a new set of challenges.
While the virus is “not a death sentence,” it’s “not a cake walk” either, said Dr. Kelly Gebo, a doctor and researcher at Johns Hopkins Bloomberg School of Public Health. She treats many infected patients over age 50. “The medications have toxicities and are not easy to take,” she explained.
Among the issues older people face are weaker immune systems that have a harder time fighting off infections, toxic side effects from medications, and co-morbid diseases that may stem, at least in part, from the aging process. “They appear to be prematurely aging,” said Gebo, noting that people over 50 have higher rates of malignancies, as well as cardiovascular disease and strokes.
New Face of AIDS
This older group represents a new face of the HIV/AIDS epidemic. About 29 percent of all people with AIDS (acquired immunodeficiency syndrome) in the United States are age 50 and older. (AIDS is the serious disease that can develop from the human immunodeficiency virus, better known as HIV.)  In some cities, as many as 37 percent of people with AIDS are in this age group.
Meanwhile, the rates of HIV/AIDS among older people are 12 times higher for blacks and five times higher for Hispanics compared to whites. Also, in the last decade, AIDS cases in women over 50 were reported to have tripled; heterosexual transmission rates in this age group may have increased by as much as 106 percent.
These adults represent the first generation of older adults living with HIV. Most are in their 50s, but some are in the 60s, 70s, 80s and even 90s. Also, while some of these cases are newly acquired, most are people who have been living with the disease long-term, perhaps 10, 15 or 20 years or more.
“We are working with the first-ever generation of older people growing old with HIV,” noted Karen Taylor, director of advocacy and training for the organization SAGE (Services & Advocacy for GLBT Elders).
Lack of Education, Awareness
One reason why this older cohort is succumbing to the illness is because of lack of understanding, education and testing of older adults, several resources say.
Many older people, because of divorce or the loss of spouses, are dating again. They may not realize the risk of contracting HIV because they were not raised in the “safe sex” era. Older women, in particular, may believe they are immune to the virus because they are beyond childbearing age. (Older women actually may be more susceptible because of a decrease in vaginal lubrication and thinning vaginal walls that can put them at higher risk during unprotected sexual intercourse.)


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