As the number of HIV-positive Americans over 50 grows, a study shows that this group is likely to have high rates of depression, and many of them have numerous age-related medical conditions that are complicated by their already compromised health.

The comprehensive study, Research on Older Adults with HIV, reports on the complex health and personal problems juggled by aging HIV-positive Americans. The results will be presented at the 16th International AIDS Conference in Toronto, which begins Aug. 13.

More than 1 million people in America are living with HIV/AIDS, the Centers for Disease Control and Prevention recently reported. The number of people over 50 with HIV/AIDS is growing significantly despite the fact that new HIV/AIDS diagnoses are not increasing in that age group.

It's the "graying" of HIV/AIDS, says Stephen Karpiak, research director of the AIDS Community Research Initiative of America, lead study author and a former research scientist at Columbia University Medical School. He credits anti-retroviral drugs introduced in the mid-'90s with the fact that people with HIV/AIDS are living longer.

The study was done last year in New York City. (Of 100,000 New Yorkers living with HIV/AIDS, 31% are over 50, according to the New York City Department of Health and Mental Hygiene.) Researchers asked 1,000 HIV-positive adults over 50 about their sexual behavior, health status and numerous other key issues, such as support networks and mental well-being.

Almost 67% of study subjects said they were heterosexual. Seventy percent lived alone, and 82% were not working. More than half were on disability. Many had age-related conditions such as arthritis, high blood pressure, vision loss and diabetes.

Brenda Lee Curry, 61, a great-grandmother from New York who has been HIV-positive since 1985, takes as many as 10 medications a day for HIV, high blood pressure and hepatitis, among other conditions. Curry says she developed neuropathy — trembling in her hands — from mixing so many medicines. She also has had depression and has had trouble finding resources for older women with HIV. "But at this point, I do not let this disease define me," says Curry, who founded Copasetic Women, a support group for HIV-positive women over 50.

Understanding how an HIV-compromised immune system is affected by normal age-related conditions could improve the quality of life for many HIV-positive seniors, Karpiak says.

Another significant finding: HIV-positive adults experience high levels of depression, almost 13 times higher than the general New York City population. The stigma of HIV is pervasive, which probably plays a major role in the higher rates of depression, Karpiak says. Fewer than half of the study subjects have shared their diagnosis with their families; only 35% have told friends. They keep their diagnoses to themselves "possibly out of guilt or fear of rejection," he says.

Karpiak and his colleagues say the study reveals a fragile health care system that is under-serving older people with HIV/AIDS. They're concerned that conditions will only get worse. But, Karpiak says, "it's also the beginning of learning how to best sustain the health and quality of life for the aging HIV-infected population."