What is HIV?
Human Immunodeficiency Virus, better known as HIV, was discovered about 20 years ago. This deadly virus attacks the immune system by killing certain types of white blood cells, making the infected person extremely susceptible to illness. It is not until these immune system cells have been nearly destroyed that a person begins to experience an increase in infections. This increase is called Acquired Immune Deficiency Syndrome, or AIDS. HIV is a slowly progressing disease, taking anywhere from 2 to 10 years to develop into AIDS; during that time, an infected person may or may not exhibit symptoms of illness.
Why should I care about HIV and AIDS?
While many people still view HIV and AIDS as a young person’s disease, older people are also affected. Nearly 23% of the total cases of HIV nationwide are reported in persons over the age of 50 (Centers for Disease Control, 2001). Unfortunately, older adults have not traditionally been targeted to receive even the most basic HIV/AIDS education and prevention information. As a result, HIV infection rates among adults over 50 have continued to grow. Despite misconceptions that HIV/AIDS only affects young people, it is important to emphasize that older adults have the same risk factors for HIV infection and transmission as younger people.
How is HIV transmitted between people?
HIV is primarily transmitted by contact with an infected person’s bodily fluids, specifically blood, semen, or vaginal secretions. The virus may also be present in other fluids, such as urine, saliva, or tears, however, the quantity is not enough to produce infection.
Persons may come in contact with the virus in three ways:
- Sharing needles
- Receiving tainted blood products. In the past, blood products used during transfusions were contaminated with the virus; however, tougher standards for testing donated blood have made these products safer. Needles used to inject illegal drugs (such as heroin) or prescription drugs (such as insulin) pose a much greater danger because of a lack of sterilization.
- Sexual intercourse: practicing “unsafe sex” is one of the primary methods of HIV transmission among older adults. HIV is transmitted much easier by a male infected partner during intercourse, although it is not uncommon for an infected woman to transmit the virus to her partner.
How can HIV be prevented?
The best way to prevent HIV is to minimize exposure to bodily fluids. This means avoiding contact with blood by not sharing needles and using latex barriers (such as condoms) during each act of sexual intercourse. Another important step in the prevention effort is to be tested for HIV. There are two types of tests:
- Anonymous testing: means no personal information will be used to identify your results.
- Confidential testing: means your test results will be available to anyone with access to your medical information, such as doctors or insurance companies.
Minorities and women at greatest risk
HIV/AIDS is increasing most rapidly among minorities and women. Although the highest number of persons diagnosed with HIV/AIDS are younger than 50, the number of new cases among minorities over the age of 50 is increasing. Poor health, greater vulnerability to disease, and lower socioeconomic status could possibly lead to compromises to the immune system that make older minorities more vulnerable to HIV infection.
Women over 50 are more likely to contract the virus from their sexual partners. In general, older women may be reluctant to ask their male partners to practice safe sex and may not be familiar with safe sex precautions.
HIV/AIDS has been referred to as “the great imitator” because many of the early symptoms of infection mimic the aging process. As a result, older adults who experience night sweats, chronic fatigue, and/or vision problems may think these symptoms are a result of the normal aging process. Even those who believe they have a more serious health condition may not suspect HIV because they are not aware they are at risk. Research has shown that adults between the ages of 50 and 75 are less likely to be tested for HIV (Stall & Catania, 1994).
Many older adults who have been diagnosed with HIV or suspect they have the disease often delay medical treatment because of how they interpret their symptoms. Reasons for not having an HIV test include attributing symptoms to other illnesses, perceiving an absence of symptoms, thinking that one is not at risk, and denial.
Wouldn’t my doctor know if I had this disease?
Detection, diagnosis, and treatment of HIV/AIDS may be more difficult among older persons because health care professionals may not be trained to recognize symptoms of HIV in the older adult population. Detection is especially difficult among older minorities because symptoms may be overshadowed by other chronic conditions, such as diabetes, depression, and dementia, which occur more frequently among minority adults.
Treating older persons with HIV/AIDS requires attention to other medications prescribed for additional health conditions such as heart disease and high blood pressure. Additionally, the drugs currently available to treat HIV have been primarily tested on younger adults, therefore, the exact side effects and treatment outcomes may differ for older adults. It is important for physicians who treat older adults with HIV to distinguish symptoms of HIV from those of normal aging. In order to effectively diagnose and treat persons over 50 with HIV/AIDS, health care professionals must educate themselves about HIV/AIDS among the older adult population.
Older adults cannot adequately assess their real risks of contracting or transmitting HIV if they do not understand the nature of the virus. Older adults must also be educated in order to recognize the symptoms of HIV/AIDS and seek appropriate and timely medical care.
What resources are available to help me?
Historically, the bulk of HIV prevention education has been aimed at young persons. Creating educational resources for older adults is a new challenge for the HIV/AIDS prevention community. Many organizations that serve older adults have begun to create and implement programs that address the needs of older adults diagnosed with HIV/AIDS.