Silence the Dialogue about HIV/AIDS

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On December 1st, communities of all socioeconomic backgrounds will come together to commemorate yet another World AIDS Day. And, while there have been many advances in response to the HIV/AIDS epidemic over the past two decades, the fight to rid the world of HIV/AIDS continues. HIV/AIDS is a constant dialogue that requires strong and committed leadership that must be demonstrated at every level to get ahead of the epidemic–in families, in communities, in countries, and internationally because people are still dying. Seniors are dying at alarming rates!

With the emergence of drugs like Viagra and not having to worry about unplanned, unwanted pregnancies anymore both women and men are having frequent and often time's unprotected, risky sex. Seniors are unlikely to consistently use condoms during sex because of a generational mindset and unfamiliarity with HIV/STD prevention methods. Consequently, the risk of exposure to HIV for older Americans is ever growing. Between 11% and 15% of U.S. AIDS cases occur in people over age 50, and the numbers are expected to increase as people of all ages survive longer due to triple–combination drug therapy and other treatment advances. Yet, the rate of HIV infections (not AIDS) in seniors is especially difficult to determine because older people are not routinely tested.

Knowing this, the National Caucus and Center on Black Aged Inc. (NCBA) is making a concerted effort to teach seniors how to become advocates for their own health. Often times, clinicians are reluctant to discuss or question matters of sexuality with aging patients or clients. As HIV symptoms often are similar to those associated with aging (fatigue, weight loss, dementia, skin rashes, or swollen lymph nodes) misdiagnosis is frequent in older people who are in fact, infected. Older persons are first diagnosed with HIV at a late stage of infection, and time and again become ill with AIDS–related complications and die sooner than their younger counterparts; these deaths can usually be attributed to original misdiagnoses.

Also, due to the general lack of awareness of HIV/AIDS in older adults, this segment of the population, for the most part has been omitted from research, clinical drug trials, educational prevention programs and intervention efforts. There are few educational prevention programs and intervention efforts that show a wrinkled face on the outreach materials. So, unfortunately when most seniors think about HIV/AIDS, they think about young, gay, white men. And, that simply is not the true. The face of HIV/AIDS is anyone and everyone. It is the face of your grandmother, grandfather, or you!

While men who have sex with men form the largest group of AIDS cases in the over 50 population, the number of cases in women infected heterosexually have been rising at a higher rate and comprise a greater percentage as age increases into the 60's and older. Furthermore, because of stigma, it can be difficult for seniors–women, in particular to disclose their HIV status to family, friends and their community. For example, for older women there are special considerations after menopause, condom use for birth control becomes unimportant, and normal aging changes such as a decrease in vaginal lubrication and thinning vaginal walls can put them at higher risk during unprotected sexual intercourse. Yet, little in the public dialogue speaks to the special considerations that impact women or men for that matter leaving both are uninformed about HIV transmission.

In addition to the lack of programs and intervention efforts, seniors are often times met with the cultural attitude that assumes elderly people have lived their lives, so what if they die from AIDS? With that, seniors often times are less likely to find support and comfort among family and friends because they are traditionally not comfortable in support groups, they may be less inclined to join them, citing lack of shared experiences concerning different issues. Or, because the aging process itself lowers energy levels and results in restrictions in social routines which can cause emotional/psychological problems, the older adult infected with HIV may feel another "loss" and endure severe depression. Seniors suffer from two stigmas. One is the stigma of living with a disease that is transmitted sexually or through drug abuse, and the other is the stigma of being old.

As a leader in minority aging, NCBA wants seniors to know that if YOU can get HIV/AIDS even if you are over 50. If you are sexually active, having unprotected sex, and/or a recreational drug user you are at risk for HIV. There is no getting around it! Bottom line: become an advocate for yourself or someone else. Join forces with your local, state, or national leaders to help silence the dialogue around HIV/AIDS.

To learn more about more about HIV/AIDS in older adults or the upcoming workshops, contact the National Caucus and Center on Black Aged, Inc. at 202–637–8400 or visit www.ncba–

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