Seniors have sex and should get tested, HIV researchers say
Many people at risk for contracting HIV aren’t getting tested for the virus or being targeted for preventative efforts, because they are – in a word – old.
Research from a one-year-old study (PDF) produced by the Gay Men’s Health Crisis and presented at this year’s national Creating Change conference shows that the number of seniors living with HIV and AIDS is growing — likely perpetuated by a lack of sex education for older adults combined with poor knowledge of seniors’ risky behavior.
People over 50 make up about one-third of all people living with HIV/AIDS, and that number is expected to grow to one-half by 2015, according to the report.
Generally, HIV-positive persons over 50 fall into three categories, explained Daniel Tietz, executive director of the AIDS Community Research Initiative of America (ACRIA), who presented this data along with three other researchers. These are: longtime HIV/AIDS survivors, newly diagnosed individuals, and newly infected individuals. The data suggests that longtime survivors make up the largest group; however, the latter two groups are growing steadily.
According to the report, older women newly diagnosed with HIV generally become infected through unprotected heterosexual sex or injection drug use. For older men, homosexual sex is the likely cause of HIV infection, followed by injection drug use and heterosexual sex. The report notes that among people who are older than 50, African-Americans are 12 times as likely as white Americans to have HIV; Latinos are five times as likely.
Tietz said that data on people with HIV/AIDS is poorly collected by the Centers for Disease Control and Prevention; the agency does not provide specific data broken down by age and risk category for older adults as it does for youth.
A group at the highest risk for HIV are transgender people, particularly transgender people of color, Tietz said. In part, he explained, it’s because transgender people have difficulty finding work due to discrimination; thus, many turn to sex work. And until recently, he said, the CDC classified transgendered people as gay, effectively muddying the numbers of both communities.
Ask seniors about sex and drugs
Elizabeth Lovinger, a policy associate at the Gay Men’s Health Crisis, said that her organization has recommended that doctors make it a habit of offering cervical- and anal-cancer patients an HIV test, as those diseases could be an indicators of the virus.
“We need to be targeting behaviors instead of identities,” Lovinger said.
What Tietz wants to see happen is more doctors talking to their senior patients about their sex lives and drug habits – something he doesn’t think happens much now.
“The stereotype is that older people don’t have sex,” he said.
This stereotype was challenged last summer with an ACRIA-designed billboard campaign in New York City. Transit hubs were adorned with signs featuring older Americans — who appear to be nude — and the slogan “Have sex? Age is not a condom.” Tietz said the city council and the state aging office, which funded the project, didn’t want their names on the posters.
Additionally, ACRIA was unable to put the signs near schools or churches, due to a city ordinance banning words like “sex” and “condoms” near those locations. Tietz said his organization is looking for ways to get around that loophole. Washington, D.C., might be seeing a similar campaign soon, he said.
A new study funded by the Health & Human Services in partnership with the Center on Halsted, examined social needs in aging adults with HIV in the Chicago area. The study found that HIV-positive seniors were more likely than HIV-negative peers to suffer from depression, substance abuse and financial hardships. Britta Larson, the center’s senior services director, who worked on the study, said participants were desperate for the $25 gift certificate that served as an incentive.
Reauthorizing the Older Americans Act
Aaron Tax, director of federal government relations for the Services and Advocacy of GLBT Elders (SAGE), said one way for the federal government to address the rising HIV-positive senior population is to reauthorize the Older Americans Act, with amendments that modernize the 1965 act. U.S. Sen. Bernie Sanders (I-Vt.), who chairs the Senate Health, Education, Labor, and Pensions (HELP) Subcommittee on Primary Health and Aging, introduced a reauthorization bill last week.
Among the programs funded by the OAA — whose funding has remained flat for years, Tax said — include home-delivered meals and transportation, employment, and legal assistance.
SAGE and the National Gay and Lesbian Task Force have also proposed amendments to the OAA, which include expanding the definition of “vulnerable elder” to specify lesbian, gay, bisexual and transgender older adult and to mandate that programs and services are evaluated for their efficacy at reaching LGBT adults.
Tax said he thinks the bill won’t pass this year; he noted that the ranking Republican on the HELP subcommittee is Sen. Rand Paul (R-Ky.), known for being anti-government.
Tax argued that the OAA “is a very small investment with a huge return.”