HIV Among Older Adults: Age-Specific Issues in Prevention and Treatment

Nathan L. Linsk, PhD

Disclosures

AIDS Read. 2000;10(7) 

In This Article

Editorial Comments

Dr Linsk's overview of the prevention and treatment issues surrounding HIV among older adults addresses an age group that has been overlooked or ignored by many throughout the pandemic. The number of persons receiving a diagnosis of HIV infection at age 50 or older rose to 78,197 by the end of 1999, continuing to represent more than 10% of all HIV-infected people in this country aged 13 and older. Furthermore, the number of those aged 65 or older at the time of diagnosis (10,002) continues to surpass that of those under age 5 (6753).[1] Consequently, it is imperative that we respond more effectively to prevent the continuing repercussions of the epidemic at all stages of life. The most important goal is to increase our awareness of and attention to the fact that HIV infection and AIDS are not the province of any particular age group, and no one should be dismissed from education, intervention, or treatment because of his or her chronologic age.

Although middle-aged and older persons have always been affected by HIV, Dr Linsk's explanation of the relative definition of "older adult" illustrates why the needs and concerns of those in their 50s and older have not been embraced by providers of services to the elderly. The category of 50 and older is an artifact of the early age categories used to present epidemiologic data. For reasons outlined in the article, it may make sense at times to keep that floor when discussing older adults and HIV. The distinction, however, also shows how this construction of age categories has discouraged middle-aged and older persons from identifying themselves with any aspect of HIV, has marginalized those who are defined as "elderly," and has resulted in people over 50 having to embrace 2 stigmatized categories when confronting HIV (being "old" and being HIV-positive).

The stereotypes attached to society's notions of age-appropriate behaviors have hindered the inclusion of older people in every aspect of HIV-related activities. Whether it is discomfort with the image of sexual behavior in later years -- the assumption being that older adults are not willing to talk about sexual activities and issues of risk -- or the failure to acknowledge the use of illicit drugs by older adults, excuses have been made by older people and the professionals who serve them denying the real risks of HIV/AIDS. By looking past the stereotypes and acknowledging that older people continue to become infected in later life and that more young people will be aging with HIV, there is a tremendous opportunity for practitioners and service providers to increase collaboration and expand efforts to include older persons.

By incorporating a life course perspective into all aspects of HIV services, education, intervention, and support, we would increase inclusion and be able to provide services to patients as they assume different roles and activities, face challenges, and seek opportunities throughout life. Dr Linsk points out the many changes that occur in physical functioning and social networks as we age and points to the places where experts in aging and HIV are dealing with common concerns and similar challenges. This is the time to explore and make use of the intersection of HIV and aging as a way to enhance the care of affected persons, no matter what their chronologic age.

Diane Zablotsky, PhD
Associate Professor of Sociology
University of North Carolina, Charlotte

  1. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report. 1999;11(2):16.

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