March 2002

NEAC Board Commits to Program for Older Americans

Although much is heard about the rise of HIV infection in young people, the increasing number of people aged 50 and beyond who are becoming infected is rarely discussed. The NEAC board, meeting in Phoenix in January, voted to embark on a new education and prevention program for older Americans.

According to the Centers for Disease Control and Prevention, AIDS cases among individuals over 50 have increased 22 percent since 1991, and 14 percent of all those living with HIV infection are over 50. Moreover, in the state of Florida, 25 percent of all HIV cases occur in older heterosexuals. Surveys reveal that the older American population does not view itself as at risk for HIV transmission and is therefore less likely to take precautions to avoid it.

Older Americans encounter two stigmas related to HIV/AIDS. First, people are reluctant to discuss HIV or AIDS and even more to disclose positive status, so they are unlikely to inform sexual partners. Second, older people face ageism in general. They have limited access to HIV tests, information, and age-appropriate messages. Doctors may fail to consider HIV as a possibility, wrongfully assuming that older people are not sexually active. In women, night sweats and depression may be attributed to menopause rather than HIV/AIDS.

Misdiagnosis is far more common among older Americans. It has been estimated that 40 percent of primary care physicians do not assess HIV risk in persons over 50. “That younger doctor is sitting across the desk from someone who looks like his grandmother,” said Jane P. Fowler, national coordination of the National Association on HIV over Fifty, “and he doesn’t point out the risks.”

The situation is further complicated by the fact that women over 50 may be less concerned with using barrier protections like condoms because they are unlikely to get pregnant, yet older women’s thinning vaginal walls make them more susceptible to STDs.

An article in the American Journal of Public Health last year noted that “Prior studies have shown knowledge deficits regarding HIV risk factors among providers and patients that may lead to overlooking risk-taking behavior among older populations.”

A recent study of new AIDS patients in Tarrant County, Texas (Fort Worth) found that increasingly they are over 40 and middle class. In 1993, about 26 percent of the new AIDS diagnoses were among patients 40 and over; by 2000, that number had increased to 45 percent. Moreover, they are sicker at diagnosis than in the past.

The phenomenon is not limited to the United States. Because AIDS cases among older people are on the rise in Brazil, the Health Ministry last fall decided to target older people with education campaigns and the distribution of condoms. The incidence of infection of Brazilians between the ages of 50 and 59 almost tripled between 1990 and 1998. “We are going to places where older people go, like meeting places, tourism agencies, dances, and community centers, to provide information and male and female condoms,” said Denise Doneda, the head of prevention at Brazil’s AIDS program.

We’d Like Your Help …

HIV infection in our parents and grandparents isn’t getting much press, but it is increasing and will continue to do so unless we become more active in educational efforts. We are now in the process of gathering materials that are already in print to see how a new curriculum for older Americans might be more interactive, peer-education based, and biblically grounded. With a large number of retirement and nursing facilities already owned or operated by faith-based organizations, we hope this kind of prevention material will be embraced and used.

The success of our TAP program with teens has shown us that peers working with peers is the best way of transmitting this vital life-saving information. A similar model is being looked for in this new program.

If you know of any existing curriculum or education materials that are in use, we would like to hear about them. Please send any information that you have to the NEAC office, or e-mail neac@neac.org.

The Rev. C. William Frampton III
NEAC Co-chair