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The aging of AIDS

New support method offered for older adults with HIV/AIDS

By Colleen Kiphart

The trick, Emlet says, is in managing both the virus and the process of aging, which requires concurrent expertise in infectious disease, chronic care and geriatrics. He adds that the intersection of these conditions is not well understood, and [treatment] resources are limited and concentrated in metropolitan areas.

Heckman agrees that more research is needed, “There are no long-term studies on the effects of [antiretroviral] medications. …We need to better understand how HIV medications interact with other therapies [in older adults].” 

Heckman cites data showing that people 55 and older at the time of their diagnosis have the lowest survival rate of any group and are usually diagnosed later into their illness—sometimes not until the disease has progressed AIDS.

Heckman explains that both patients and doctors often assume HIV symptoms are just part of getting older. “There’s a reluctance to think of sexually transmitted infections in older adults. Physicians don’t think of it.” Heckman recalls one HIV-infected older woman who went to 25 doctors before one asked her if she had been tested for HIV.

Many older people are often misinformed about safe sex and HIV, correlating condoms exclusively with birth control, for example. This, combined with vaginal dryness and tearing in older women, erectile dysfunction drugs, drug use and rising rates of separation and divorce, makes a perfect storm for the spread of HIV in people over 50.

The disease is not spreading evenly across demographics. While gay men still make up the majority of the HIV-positive older population, African-American women over the age of 50 are now among the most at-risk populations for contracting HIV, and diagnoses among African-American and Hispanic populations are growing at 12 and five times the rate of Caucasians, respectively.

Heckman’s next study will examine the patterns and needs among this diverse population. His work will include 360 people, nationwide, including Hawaii, urban areas, rural areas—anywhere there is a need. His ultimate goal is to “identify intervention programs that work, and help organizations and communities implement them.” 

Over the last two decades, HIV has gone from a death sentence to a manageable, chronic disease. Heckman was among the first to identify the long-term implications of this shift for older adults, and is helping them find their way to a better quality of life.

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