a publication of the sexuality and aging consortium at widener university

Older Adults are Vulnerable to HIV and other STIs

It’s World AIDS Day today, making this a good time to discuss the special risks of HIV/AIDS facing adults in mid and older age.  About 10% of all people diagnosed with AIDS in the U.S. — some 75,000 Americans – are age 50 and older. That’s the cases we know about, at least, because older people aren’t  tested for HIV/AIDS on a regular basis.

Consortium member Judith Hersh, MD, FACOG, says that condom use remains low across adult age spans, despite the effectiveness of the barriers against HIV.

“Women who relied on condoms for pregnancy prevention often stop using them when they reach menopause. Also, both men and women who have been in long-term sexual relationships may neglect to use condoms if those relationships end and they begin engaging in sexual intimacy with new partners,” says Hersh.

Hersh says older adults frequently have an “It won’t happen to me” attitude similar to the attitude of adolescents and teens. They feel somewhat immune to the potential health risks related to some sexual activities, so they don’t take precautions against sexually transmitted infections.

Logistics pose problems, too.  Older women may lack interest in using internal condoms, and male condoms can slip off softer erections.  Access to condoms may be difficult for older adults who rely on adult children, caregivers, or long-term care facility staff to purchase personal care items.

Older women are especially vulnerable to sexually transmitted infections for several reasons (Mahar, 2003):

  • Lack of mucosal integrity, vaginal dryness and thinning associated with peri-menopause and menopause
  • Clinicians don’t ask about sexual partners and may not do routine screening
  • Physical symptoms may mimic common signs of age-related genital atrophy
  • Patients may be too embarrassed to seek care

Luther and Wilken (2007) estimated that by 2015, 50% of the people diagnosed with HIV/AIDs will be older than 50, with women acquiring HIV at a higher rate than men.

For more information about HIV and older adults, click here.

References

Luther V.P. & Wilken, A.M. ( 2007). HIV infection in older adults.  Clinical Geriatric Medicine, 23, p. 567-583.

Mahar F. Sexually transmitted infections after menopause. J Brit Menop Soc.Dec 2003;173-174

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