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Studies Show Seniors at Increasing Risk of HIV Infection

WebMD Health News

Nov. 12, 1999 (Chicago) -- It seems there's a new kind of 'Happy Meal' making the rounds in buildings where elderly men live. The package consists of food, perhaps champagne, and the drug Viagra (sildenafil) for arousal. Prostitutes deliver the goodies on the day when the monthly social security check arrives in a sex-for-money transaction.

To public health officials, these senior sexual adventures are anything but harmless. Researchers at this week's 127th annual meeting of the American Public Health Association say evidence is showing that older Americans are at growing risk for contracting HIV.

"We know that older people often have trouble getting access to sex. So they may be indiscriminate about who their sexual partners are. They may be embarrassed about taking precautions," Nathan Linsk, PhD, tells WebMD. Linsk, of the Jane Addams College of Social Work at the University of Illinois at Chicago, has studied America's aging HIV epidemic with growing concern.

He estimates that about 10-15% of those older than 50 are infected with HIV. That number is similar to the general population, but Linsk insists age confers its own special risks. While many seniors are sexually active and a growing number are IV drug users, older people are more reluctant to use condoms than their younger counterparts.

Linsk points to what he calls the double whammy of "ageism and AIDSism" rendering older HIV patients increasingly on the sidelines of HIV treatment. Meanwhile, Linsk says some providers may be reluctant to start toxic multidrug therapy for AIDS in these patients, cynically assuming they have "little life left."

Postmenopausal women may be emotionally and physically vulnerable to HIV, according to several studies presented at the conference. Because so few men are available, women may be reluctant to insist that their partner wear a condom. Meanwhile, the thinning of the vaginal walls with age can make older women more prone to intercourse-induced trauma, raising the risk of contracting the disease.

While safe-sex messages and posters are virtually ubiquitous, Linsk points out that the images portray the young, not those in their golden years.

Focus groups conducted last year on New York state residents older than 50 paint a disturbing picture, says Kathleen Nokes, PhD, RN, of the Hunter-Bellevue College of Nursing. Twenty-seven percent of those surveyed thought that they had put themselves at risk for HIV through unprotected sex. About one-third admitted having sex with someone other than his or her regular partner during the previous year.

Nokes decries the lack of federal or private public health outreach to older Americans on the perils of HIV. "I think we can fix it by having a drug company like Pfizer that's selling a medication [for erectile dysfunction] and making billions of dollars on it, incorporating within their packet insert the importance of putting a condom on," Nokes tells WebMD. A Pfizer official at the meeting declined to comment on the suggestion.

In recent years, advocacy groups like the National Association on HIV over Fifty have sprung up, with goals of increasing awareness and pushing for a stronger public health response.

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