Older Lovers at Increasing Risk for Aids Virus: Experts

By Steven Edwards, Calgary Herald

March 3, 2009

Canada

The number of people over 50 with the AIDS virus appears to be rising, but public health campaigns remain largely focused on the young, global experts warned Tuesday.

One reason for the increased incidence is "older" people are more likely to have unprotected sex than younger people, the experts say in an article published in the World Health Organization's Bulletin.

This is coupled with the belief the over 50s are having more sex than people of that age group in decades past because of the availability of erectile-dysfunction drugs like Viagra and Cialis.

"It's certainly true that we in public health concentrated our attention and efforts in terms of the AIDS epidemic and screening on younger individuals because those are the ones who are at most risk," said Dr. George Schmid, a scientist with WHO's HIV/AIDS department in Geneva, and one of nine authors of the article.

"But it doesn't mean that people who are 50 and older are at no risk, and we think there is an under-appreciated number of individuals in that age group who are becoming infected."

In The Unexplored Story of HIV and Aging, the experts say the extent of the problem is difficult to define because "older individuals" are rarely included in government population health surveys. But there also has been insufficient discussion of the issue even at the patient-care level.

"Physicians don't think the (over-50s) are at risk, so they don't ask, or else they may be a bit uncomfortable asking," said Schmid. "Patients are somewhat uncomfortable talking about these things, as well."

Erectile dysfunction drugs have been around for about a decade, extending the sex life of an increasing number of people.

But the experts say the increased sexual activity may be "extending the HIV epidemic" into old age.

"No study has been done of their possible impact on the HIV epidemic, although their use in industrialized countries has been associated with risky sexual practices," the experts write.

Many separate studies have shown older people are more likely than younger ones to shun "safer" sex -- which can increase the risk of HIV infection.

The experts say a greater focus on the problem will lead to earlier diagnoses. The global average life expectancy after diagnosis is four years in those over 65, compared to 13 in people infected between the ages of five and 14. Part of the short life expectancy, however, would be due to a person's waning immunity with age, the experts say.

Public Health Agency of Canada does not separate data about HIV infection rates for people older than 49 in its HIV/AIDS Surveillance Report 2007, the most recent available.

"Seniors are not a target population" of federal HIV/AIDS programs, which focus on eight "at-risk" groups, including homosexual men, women, youth and intravenous drug users, said one PHAC official. But literature is available to all age groups.

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