Post submitted by the HRC Health & Aging Program staff
Since the first cases of AIDS were reported in 1981, advances in HIV research, prevention and treatment have helped reduce new infections and allowed people with HIV to live longer, healthier lives. New infections have declined dramatically from peak numbers in the mid-1980s, and better treatments mean that people who are diagnosed and treated early can have near-normal life expectancy.
Yet, with 50,000 new infections every year, there is still an urgent need to increase awareness of HIV and to promote the importance of prevention, testing, care and treatment. National HIV/AIDS and Aging Awareness Day, September 18, is an opportunity to focus these efforts on an often-overlooked population: older Americans.
Many older Americans remain sexually active—and they may have many of the same risk factors for HIV infection as younger Americans, including a lack of knowledge about HIV and how to prevent it, inconsistent condom use and a belief that HIV is not an issue for their peer group. Those 55 and older accounted for 17% (196,000) of the estimated 1.1 million people living with HIV infection in the United States in in 2009.
For older men who have sex with men (MSM), cumulative numbers of past sexual partners and social networks that include more HIV-positive sexual partners and acquaintances may contribute to their risk. In 2010, 44% (1,100) of new infections among older Americans were among MSM. Yet older MSM may not be aware of all of the new prevention tools and options that exist.
Testing is one of the most important steps MSM can take to protect their health and curb the spread of HIV. One-third of MSM who are infected with HIV are unaware of their infection, and only two-thirds report they were tested in the previous year, as recommended by the Centers for Disease Control and Prevention (CDC). Sexually active MSM may, in fact, benefit from more frequent testing, such as every 3 to 6 months.
HIV testing has never been easier. Rapid tests are offered in clinics and at many other settings, like Pride events and community service organizations, with results available in as few as 20 minutes. Two home testing kits are also available online or from drugstores, one of which is a rapid test. Anyone can access testing for HIV and sexually transmitted infections (STIs) by visiting the National HIV and STD Testing Resources site, texting a ZIP code to Know IT (566948) or calling 1-800-CDC-INFO (232-4636).
MSM who test negative can use the opportunity to make an HIV prevention plan so they stay negative. The CDC notes that the same basic tools for HIV prevention apply to all sexually active MSM: choosing not to have anal sex, using condoms consistently and correctly if they have anal sex, being tested at least annually for HIV (and other STIs) and choosing less risky behaviors, such as oral sex.
Newer biomedical prevention options that may be right for some older MSM are also available. For example, post-exposure prophylaxis (PEP) involves taking certain medicines as soon as possible after a single, high-risk exposure to HIV to reduce the chance of becoming HIV-positive. To be effective, PEP must begin as soon as possible, but within 72 hours of exposure at the latest, and must be taken for 4 weeks. MSM who think they may have been exposed to HIV should see a healthcare provider or go to an emergency room right away to ask about PEP.
In addition, some MSM may benefit from pre-exposure prophylaxis (PrEP), which involves taking certain HIV medications daily to reduce the risk of getting infected with HIV. The CDC suggests that MSM talk with an HIV-knowledgeable healthcare provider about PrEP if they sometimes have sex without using a condom, especially if their sex partner is HIV-positive or has HIV risks (for example, he injects drugs or has sex with others).
All those who test positive for HIV should be linked to medical care, treatment and supportive services as soon as possible, to delay progression to AIDS and to lower their risk of spreading the virus to others. Research shows that being treated for HIV not only benefits the individual but also reduce the chance of transmitting HIV to a partner. Because of all the benefits of treatment, new treatment guidelines recommend that all those who are HIV-positive be started on treatment without delay.
Today, someone diagnosed with HIV and treated before the disease is far advanced can have a nearly normal life expectancy. As a group, however, older Americans are more likely to be diagnosed with HIV infection late in the course of their disease, when the immune system has already been damaged. This may be because doctors aren’t looking for HIV infections in their older patients or because older people mistake HIV symptoms for those of normal aging. Getting on treatment early is especially important for older Americans, because without treatment they lose immune cells faster and progress more quickly to AIDS and death than younger Americans.
National HIV/AIDS and Aging Awareness Day is a reminder to keep information about HIV at the forefront of discussions about healthy aging, to promote HIV testing among MSM without regard to age and to confront the challenges that place older MSM at risk for HIV.
For more information, visit the Administration on Aging, the National Institutes of Health or Services & Advocacy for GLBT Elders (SAGE). Or check out CDC’s Let’s Stop HIV Together campaign, featuring Greg Louganis and other older men living with HIV.