The Unseen Side of AIDS: Seniors and HIV

As anti-retroviral regimens allow HIV-positive people to survive for decades, older Americans living with the virus have increased in number--but their needs are not necessarily more visible to society at large.

The New York Times in a Nov. 10 article, looked at the older demographic, both HIV-positive and HIV-negative, in light of attitudes about age and sexuality.

The article described how AID activist Myron Gold, a 67-year old who has lived with HIV for a decade and a half, has survived long enough to see AIDS transformed from a near-guarantee of a life cut short to a disease that, for the time being, can be managed with the right combination of medications.

Some younger members of the GLBT community--and of the straight community, too--see HIV and AIDS as no big deal, figuring that should they become infected, they will simply go on the cocktail. The younger set have not seen friends and relatives devoured by the disease, or witnessed the decimation that the gay community endured in the 1980s.

But the medical picture is more complicated than that, especially for older people living with HIV. The anti-retroviral regimen can have serious side effects, and as people living with the virus for years on end discover, HIV is continually adapting, developing resistance to medications.

The article quoted Gold, who was prescribed AZT upon his diagnosis in 1993, as saying, "I've been through 28 medications."

Even after all that, Gold's T-cells--the component of the immune system that HIV aggressively destroys, rendering people living with the virus vulnerable to opportunistic infections--"are low and they're not working."

As human beings age, their immune systems become less effective, and HIV can worsen that natural decline.

Other age-related health problems, such as dementia and arthritis, can also be worsened by HIV, even when individuals living with the virus are successful at keeping the level of the pathogen in their systems in check, the article reported.

Said Gold, "This is an illness about every age spectrum, from young to old."

The article reported that nearly 30 percent of those living with AIDS in America are older than 50 years. Even for older people who HIV negative, the disease is a matter of concern: society in general, obsessed with youthfulness, may not acknowledge it, but older people are still sexually active, and they, too, need to learn about safer sexual practices.

Indeed, the New York Times published a Valentine's Day article focusing on safer sex for the silver set in 2007.

The 2007 article said that driven in part by potency drugs like Viagra and medially prescribed androgens, used by men, and attitudes about sex shifting away from shame, on the part of women, more older Americans have been enjoying more sex.

But that shift has not automatically brought with it greater knowledge about the risks associated with sex, and how to manage them: the article related that in one sex ed class offered to older people, no one had seen a demonstration on how to dona condom properly.

The Nov. 10 article paired that earlier observation with a citation from the Centers for Disease Control and Prevention, which found that 15 percent of new HIV cases in 2005 involved people over the age of 50.

The article also noted that government issued guidelines advise HIV tests for people only up to age 64.

Said Gold, "What about people 65 and older?

"They're having unprotected sex, they're using drugs."

The article said that Gold has testified to Congress as well as to New York state lawmakers on the need for outreach and education for older Americans on the issue of HIV.

The article contained an anecdote from Gold's rounds as a speaker on the issue. After addressing a crowd at a Brooklyn senior center, Gold was approached by a number of women from the audience--"all over 80 years old," he said--who wanted free condoms.

"They said to me, "It's not for me, it's for my grandson,'" the article quoted Gold.