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HIV & AIDS - Older People
How many older people have aids?
Why are older people getting infected?
Is hiv disease different for older
people?
Is hiv the same in older people?
What other health problems are common?
Mental problems
The bottom line
About 60,000 people age 50 or over have AIDS in the
United States. This is about 10-15% of all people with AIDS. In some
cities, 15-20% of people with AIDS are 50 or over. The number of
older people diagnosed with AIDS is increasing. About half of the
older people with AIDS have been infected for one year or less.
Many people don?t consider age 50 to be ?old.?
However, age 50 is being used more often to keep statistics on
?older people? with HIV and AIDS.
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There are several reasons:
• Health care providers may not test older people
for HIV infection
• Lack of awareness of the risk factors for getting
HIV (see fact sheets 150 and 152)
• Many older people are newly single. They get
divorced or lose their mates. While they had a partner they may have
ignored HIV prevention messages
• Lack of HIV prevention education targeted at older
people
• Belief that HIV only affects younger people
• No training in safer sexual activities (see fact
sheet 151)
• Sharing needles with infected people (about 17% of
infections of people over 50)
• Unprotected sexual activity. This may be
heterosexual or homosexual sex. Viagra and other drugs that help men
get and maintain an erection may contribute to increased rates of
sexual activity and sexually transmitted diseases among older
people.
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The first studies of HIV in older people were done
before strong anti-HIV drugs were available. Most of them showed
that older people got sicker and died faster than younger people.
This was thought to be due to the weaker immune systems of older
people. Also, older people usually have more health problems besides
HIV.
Normal aging still leads to a decline in the immune
system. Older people still tend to have long-term health problems.
However, they do at least as well as younger patients with HIV. This
may be because anti-HIV medications strengthen the immune system.
Also, most older patients, unless they are drug users or have mental
problems, take their medications more regularly (have better
adherence, see fact sheet 405) than younger patients.
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HIV medications seem to work the same in older
people as in younger people. Unfortunately, we don?t have good
information on older people because they were usually not included
in clinical trials of new drugs. People who become infected when
they are over 50 seem to do about as well as people who started
receiving HIV treatment before age 50 and then got older.
Treatment side effects may not be any more frequent
in older people. However, changes caused by aging can resemble or
worsen treatment side effects. For example, older age is a major
risk factor for heart disease and for increasing fat in the abdomen.
Some older people without HIV lose fat that looks similar to the
changes caused by lipodystrophy.
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As people age, they develop health issues that
continue for the rest of their lives. These can include heart
disease, depression, osteoporosis (see fact sheet 557), high blood
pressure, arthritis, diabetes, Alzheimer?s disease and various forms
of cancer.
Older people often take many different medications
to deal with their health problems. This can make it more difficult
for a doctor to choose anti-HIV drugs because of interactions with
other medications.
Some HIV medications may increase the risk of
diabetes, high blood pressure, or osteoporosis. This makes it harder
to choose the right HIV regimen.
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Older people may have more problems with thinking
and remembering than younger people. These symptoms can be the same
as HIV-related mental problems. Fact sheet 505 has more information
on HIV and nervous system problems.
These problems, sometimes called dementia, are less
severe than they were before the use of strong anti-HIV drugs. It is
difficult to know what is causing mental problems in older people
with HIV. Is it normal aging, or is it HIV disease? Research studies
have linked both age and higher viral load (see fact sheet 125) to
mental problems.
Rates of depression and substance use haven?t been
well studied in older people. However, these problems may be related
to HIV disease, aging, or both. They need to be diagnosed and
treated correctly.
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The number of people over 50 with HIV or AIDS is
growing rapidly. Between 10% and 15% of people with AIDS in the
United States are over age 50.
Older people get HIV the same way as younger people.
However, they may not be aware that they are at risk of HIV
infection. They also may not know how to protect themselves from HIV
transmission.
Older people have to deal with other health issues.
These can complicate the selection of anti-HIV medications. They can
also be confused with some of the side effects of HIV drugs.
However, HIV drugs work just as well in older
people. Also, older people may be better about taking their
medications than younger people.
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