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December 1, 2010

World AIDS Day: New treatments help HIV/AIDS patients live longer, causing surge in patients over 50

NY Daily News
By Heidi Evans
When Lee Chew tested positive for HIV in 1987 at age 38, the former actor never thought he'd be around in 2000, let alone 2010.

He was convinced of that in 1996, when he was hospitalized with AIDS-related meningitis.

But with the discovery of new antiviral drugs that year, he slowly went from a wheelchair, to a walker, to a cane to riding his bicycle and reclaiming his life.

Now 61, he is among the fastest-growing population of the city's AIDS epidemic - HIV positive New Yorkers over 50.

On World AIDS Day, even as young people continue to get infected, older New Yorkers are facing medical triumphs and challenges they never imagined. They are the warriors of HIV and AIDS, the survivors who are charting a new and unknown course as they age.

"I thought I would be dead, like so many friends I saw wither and die," said Chew, a social worker who has run support groups at SAGE - an advocacy group for older gay men and women. "Only in my 50s did I start to believe that I would reach early old age."

City statistics are eye-opening. Of the 107,177 New Yorkers living with HIV or AIDS, 75% of them are 40 and older. Some 37% are 50 and older, the Health Department says.

Dr. Theresa Mack, the associate medical director of St. Luke's-Roosevelt's AIDS clinic which sees 1,500 patients a year, said she is seeing more newly diagnosed men and women over 50.

"That is the shocking fact," she said. "We want to test everyone."

The oldest patient is 85.

And with a new state law that goes into effect Jan. 1 mandating that everyone be offered an HIV test when they see a doctor, she expects the numbers will grow.

Mack said older women who are newly divorced or widowed start dating again and "think because they can't get pregnant anymore they can't get infected with the AIDS virus.

"If you are sexually active - no matter how old you are or if you are male or female - you are at risk of getting HIV if you don't use a condom."

The life-saving drugs are not without side effects, and it is still too early to tell what long-term effects they - or the virus - might cause.

Doctors are seeing an increase in diabetes and heart disease, cancers at a younger age, more brittle bones, and peripheral neuropathy - nerve damage that causes burning foot pain.

"We don't know why it's happening," said Stephen Karpiak, research director at ACRIA (AIDS Community Research Initiative of America) and author of one of the only comprehensive studies on HIV and aging. The study also showed that older New Yorkers with HIV often feel stigmatized and isolated, especially after having lost so many friends to AIDS.

One of the best-known survivors is Larry Kramer, the AIDS activist and playwright who first sounded the alarm in the 1980s. Now 75, he is alive and well, after living with HIV for more than two decades, and undergoing a liver transplant 10 years ago.

Sitting in his sunlit apartment off of Washington Square Park with his dog Charlie, he is finishing a 4,000-page novel on the history of America and AIDS and is looking forward to a new staging of his acclaimed play "The Normal Heart" next year.

He takes seven pills a day to keep going, works with a trainer twice a week and, for the most part, feels fine.

"Growing old presents a lot of problems for anybody," said Kramer, who wears a hearing aid. "For people with HIV-AIDS, it's another burden to add to the ones you already have. It's really a double whammy."

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