Yet research and experience shows that few aging and health professionals are equipped to address the unique needs of older adults with HIV; public policies rarely consider older people with HIV or provide sufficient funding for programs, research and other interventions that could improve the quality of life for older adults with HIV; and the public conversation on both aging and HIV/AIDS generally leaves out what it means to live and age with HIV—especially as diverse LGBT communities.
The demographic face of HIV/AIDS is a graying one. Research shows that by 2015, one in two people with HIV/AIDS will be age 50 and older. Overall, the rates of HIV/AIDS among older adults 50+ have increased more than 61 percent from 2001 to 2007. This population of older adults with HIV/AIDS includes long-time survivors, newly diagnosed people (often late) and newly infected people. The advent of HIV medications in the 1990s has allowed many people to survive and age with HIV—a first for this generation.
Infections are on the rise among older people. The latest national data show that adults 50 and older account for 17 percent of all new HIV/AIDS diagnoses and 29 percent of all persons living with AIDS. Despite the rise in HIV infections among older people, few prevention efforts explicitly target older adults with age-sensitive information and education.
HIV/AIDS disproportionately affects LGBT people and people of color. Some studies have found that gay and bisexual men are 44 times more likely to contract HIV than other men, while African Americans and Latinos are 12 and 5 times more likely to be HIV positive than their peers. Transgender people are also at a high risk for HIV. Read a report on transgender older adults. ▶
HIV is also a concern for lesbian and bisexual older women. According to the Lesbian AIDS Project report, some lesbians, bisexual women and WSW engage in high-risk behaviors for HIV transmission, including having oral sex without a protective barrier, sharing sex toys without a protective barrier and/or disinfecting them after use, and sexual play that involves the potential exchange of vaginal fluids. In addition, some lesbians, bisexual women and WSW have sexual histories with HIV-positive men or intravenous drug users, and have self-reported participating in sex work for money or drugs—behaviors and experiences that pose great risk for HIV/AIDS infection.
Older adults are often not tested for HIV because of providers' misconceptions that they are no longer sexually active. Further, many LGBT older people often delay medical care for fear of discrimination. Our experience shows that medical providers are less likely to ask older patients about sexual activity—including numbers of sexual partners, using protection and other factors related to HIV/AIDS—due to their own discomfort as well as a common, but mistaken, belief that older adults are not sexually active. Research shows that heterosexual and LGBT older adults are sexually active well into their mid-80s, with a 2007 national study showing 53 percent of adults age 65-74 and 26 percent of adults age 75-85 as being active with one or more partners.
SAGE's programs on HIV and aging. SAGE provides essential services to LGBT older adults with HIV in New York City by partnering with local agencies that reach aging, health and social service providers. At the national level, SAGE provides cultural competence training for mainstream aging providers on these issues through SAGE's National Resource Center on LGBT Aging. Read through the National Resource Center's HIV/AIDS resources. ▶
SAGE's advocacy efforts on HIV and aging. SAGE's federal advocacy works in partnership with the AIDS Community Research Initiative of America and the Gay Men's Health Crisis (GMHC). Our policy goals include: defining older adults with HIV as a population in "greatest social need" in the Older Americans Act; improving epidemiological surveillance systems and data collection at the CDC on older adults with HIV; supporting demonstration projects and Special Projects of National Significance through HHS; instituting routine HIV testing for all adults without regard to age or risk factor; increasing federal funding of research and programmatic interventions on older adults with HIV; and more. Read a SAGE blog posting on AIDS.gov at the US Department of Health and Human Services. ▶
To learn more about HIV and aging, please contact Robert Espinoza, Senior Director for Public Policy and Communications at 212-741-2247 or firstname.lastname@example.org.
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The graying of AIDS: living longer with HIVBy Michael K. Lavers
Reality Check: The LGBT Community Must Look at the Changing Face of AIDSBy Daniel Tietz, Marjorie Hill, PhD. and Michael Adams
National Resource Center on LGBT Aging Introduces Resources on Older Adults Living with HIV
New resources, launched on National HIV/AIDS and Aging Awareness Day, highlight the needs of LGBT adults age 50 and over with HIV/AIDS.