HIV prevention for people over 50 is an important health concern, especially as the U.S. population grows older. Scholarly research has identified the need for HIV/AIDS interventions in the population of people over age 50, but few interventions have been established. The ecological perspective, which integrates intrapersonal, interpersonal, organizational, community, and policy factors, was used to review the current interventions and propose possible new HIV/AIDS prevention efforts for older adults. Intrapersonal interventions are often based on the health belief model ( Jacobson, 2011)
When people think of those populations most impacted by HIV/AIDS, older persons are often the last to come to mind. However, older people are at increasing risk for HIV/AIDS and other STDs. A growing number of older people now have HIV/AIDS. People age 50 and older represent almost one-fourth of all people with HIV/AIDS in the U.S. because older people don't get tested for HIV/AIDS on a regular basis, there may be even more cases than currently known (CDC, 2012).
Many factors contribute to the increasing risk of infection in older people. In general, older Americans know less about HIV/AIDS and STDs than younger age groups because the elderly have been neglected by those responsible for education and prevention messages. In addition, older people are less likely than younger people to talk about their sex lives or drug use with their doctors, and doctors don't tend to ask their older patients about sex or drug use. Finally, older people often mistake the symptoms of HIV/AIDS for the aches and pains of normal aging, so they are less likely to get tested (CDC 2012)
Individuals 50 years of age or older continue to account for at least 10% of AIDS cases reported to the Centers for Disease Control and Prevention in recent years. Little research is devoted to addressing the specific issues affecting diagnosis, treatment, and prevention of AIDS in older Americans (Chiao, et,al 2013)
A recent study (Stall & Catania, 1994) that used data from the National AIDS Behavioral Study explored the prevalence of AIDS risk among people over age 50 in the United States. Approximately 10% of this age group was found to have at least one risk factorf or HIV infection. The researchersd eterminedt hatt he people over age 50 who were at risk for AIDS were one sixth as likely to have used condoms during sex and one fifth as likely to have been tested for HIV as a comparison group of at-risk individuals in their twenties. Similarly, Rose (1995) reported that the majority of at-risk older people surveyed did not use condoms and had not been HIV-antibody tested. With the emphasis of AIDS education and AIDS prevention messages almost exclusively on the young, it is not surprising that older adults at risk appear to be less likely to have adopted behaviors that can slow the spread of HIV infection (Stall & Catania, 1994).
The prevalence of HIV/AIDS in older adults continues to increase, and in 2005, 25% of those infected with HIV were older than 50. Successful treatment regimens allow people to live longer with HIV, but the incidence is also increasing, with older adults accounting for 15% of new HIV cases in 2005 ( ncbi.gov)
Prevention, diagnosis, and management of HIV/AIDS in older adults are complex issues. The aging immune system may impact response to treatment with highly active antiretroviral therapy (HAART), and there is greater potential for drug-drug interactions and toxicities due to comorbidities and polypharmacy. Patients living longer with HIV are more likely to develop diseases associated with aging, and at an earlier age, than those without HIV. These include coronary artery disease, dyslipidemia, metabolic syndrome, diabetes, osteoporosis, and dementia. Geriatricians and primary care providers are increasingly responsible for managing these complex issues (ncbi.gov)
Survival rates among elderly individuals infected with human
