Menus Subscribe Search

Follow us


The Over-50 Crowd Relearns the Facts of Life

• April 02, 2008 • 11:33 PM

HIV infection is a growing fact of life for America’s baby boomer population. But it’s a fact both the aging and their caregivers are spectacularly unprepared to address.

Read part one: Aging With HIV

For years, single seniors would find the idea of meeting new people following a divorce, or loss of a partner, daunting at best. But with today’s online dating services, success in finding the perfect partner is ostensibly only a click away — all you need is a computer and a little courage.

But Jane Fowler, retired journalist and now HIV/AIDS prevention educator, waves a red flag of caution for older singles. As founder and director of the national HIV Wisdom for Older Women, Fowler says that older single people — “the fastest-growing segment of the dating services” — may put themselves at risk by engaging in new relationships.

“The perception among both the older, public population and providers of health and social services is that seniors are not at risk for sexually transmitted disease, and as a consequence they have low awareness about HIV,” Fowler said.

While HIV can pose health problems at any age, there is additional risk of having the virus as an older person. People 50 and over have less vigorous immune systems, and studies report that a majority of older adults have at least one or more chronic, age-related condition such as diabetes, arthritis or heart disease.

Fowler, a vibrant and active senior, has a personal commitment to HIV awareness for women over 50: She was diagnosed HIV positive in the mid-80s, having been exposed to the virus from an unprotected, heterosexual contact following her divorce.

“I am very concerned about women who, like me years ago, may be re-entering the dating scene after an absence of several decades,” she said.

The Myth of Age-Related Immunity
According to Fowler, AIDS cases in women over age 50 are reported to have tripled in the last decade. Furthermore, the findings of the recent landmark ROAH (“Research on Older Americans with HIV”) study reported conclusive evidence that heterosexual contact is now the predominant mode of virus transmission.

“It is important to get the message out,” Fowler said, “to both women and men over age 50, that unprotected sexual contact is a risk.”

She said physicians do not typically discuss sexual behavior with their older patients, and this fosters a false sense of security that age imparts “some special kind of immunity.” Plus, as people age and their immune systems weaken, many of the symptoms of age-related conditions, such as fatigue, dementia, weight loss and skin rashes, are very similar to those of HIV.

“When these symptoms are overlooked and attributed to natural aging, people who are HIV positive end up walking out the door,” she said. “By the time they are diagnosed, they may be very ill and the window of opportunity to begin a therapy that helps prevent the virus from progressing to AIDS has already passed.”

However, the problems of older people affected by HIV are, “much more than physical ones and a regimen of taking pills, ” said Dr. Stephen Karpiak, lead investigator of the ROAH study. While the latest antiretroviral drug therapies allow people to live longer and healthier, their research data on the quality of life “paints an unsettling picture of the older person with HIV.”

“More often than not, these older, HIV-positive adults are not only alienated by friends and family, they are afraid to disclose their status, and have few places to turn to for help,” said Karpiak, who described “help” as “the little things that make the big difference.”

“We’re talking about having someone to help buy groceries, take you to the doctor or to church,” he said. “Our study reported just how disconnected these people are from society — not just from their disease and its stigma but also because they are old with this disease.”

There’s a stereotype of older people as being no longer productive, with failing mental competency and low value to society. “There is this prevailing cultural attitude,” recounted Fowler, “of ‘so what if old people get HIV and die?’ — the assumption being that they have already lived their lives and are no longer productive contributors.” 

Need for Community Involvement
Dr. L. Jeannine Burkhardt-Murray, medical director of Harlem United Community AIDS Center, who helped Karpiak write the spirituality component of the ROAH study questionnaire, adds another dimension to the picture of social disconnection.

“Informal care giving by friends and family is provided to millions of people in this country who have chronic illness, disability, are elderly, or just need some day-to-day maintenance help,” she explained. “But older people with HIV are often stepped over from potential sources of assistance because of persistent stigma and lingering misconceptions about virus transmission.”

She added: “(It is) so unfortunate because we know that people who have outside contact with the community — not just the health arena of their doctors and nurses but with friends and family members — these are the ones who do the best.”

Burkhardt-Murray said she has spent time over the years trying to engage local leaders of the religious communities into supporting people with AIDS.

The dilemma, said Burkhardt-Murray, who lives and works in the largely African-American community of Harlem, is that this is a population largely estranged by their family and friends who would turn to their church but find themselves unwelcome.

“For many years our clergy would not acknowledge this disease,” she said. But after more then a decade of advocacy, she sees things changing and the church is now more willing to talk openly about HIV with its constituency.

This is good news since one of the ROAH findings, she said, is that many older HIV-positive people “expressed a positive benefit from a religious or spiritual affiliation.”

An Intergenerational Approach to Breaking Barriers
For Ed Shaw, a tireless, 60-something-year-young HIV educator and chair of the New York Association of HIV Over 50, just “getting people to talk about this disease is an important step and can make a difference, one person at a time, to overcoming barriers.”

Like Fowler, Shaw’s mission for more than a decade has been to bring awareness to the risks of HIV in older people.

“I think that what we really need now is a bold, new vision, some real ‘out-of-the-box’ thinking,” he said, explaining that his mission is to “tear down the wall” of barriers in communicating about HIV.

He developed what he calls the “intergenerational approach” to communicating about the virus. “What we need to do is connect whole families to start talking about health in general,” he said, explaining that young people who are more likely to talk about sensitive issues like sexually transmitted diseases and AIDS can break down the barriers to talk candidly with the “older generations.”

“I think when you get different generations to all sit down together — parents, kids, grandparents, aunts, uncles, whomever —you can all learn from each other, and this is key to breaking down traditional taboos of discussion,” Shaw said.

Diagnosed HIV positive more than two decades ago, Shaw spends a lot of time in New York’s community senior centers spreading his enthusiasm and “tearing down the wall” on HIV discussions. He says his “soft-sell approach works well” — using raffles, screenings and health fairs to promote senior attendance to his programs.

“Telling this story to older people is more than renting a space and handing out brochures,” he said. “If you advertise ‘come and learn about HIV in the elderly’ you’ll be talking to an empty room! I get people together to talk about aging and health from a wellness approach, then, we can introduce HIV as a discussion point.”

Public Policy Recommendations for Unmet Needs
Based on the findings of the 1,000 participants of ROAH, the first study of an HIV-positive population age 50 and over, Karpiak and his colleagues have outlined policy recommendations that are needed to address the multiple social and health delivery issues of this marginalized population.

“There needs to be action on three fronts,” he explains, “health care, and clinical research, and social policy.”  The shorthand message is to educate physicians and advance an awareness of this aging population with HIV, to conduct research to learn about physiological effects, and develop programs to address unmet social needs.

“We need to address the problem of stigma and conduct public education and outreach awareness that targets the general public, and to also create prevention messages that targets older people,” Karpiak said. “The medical community needs to realize all patients are at risk, and that those older people who have the virus need a different kind of care than someone who is in their 20s or 30s.”

Karpiak calls for amendments in the Older Americans Act and its Caregiver Support Program elements. “We’d like to see HHS make specific provisions in programs and services and fund the Agency on Aging to pay for education and training,” he said.

The researchers also envision local AIDS service organizations as the ideal resource who can provide specialized training to Area Agencies on Aging, to home health services and to other community outreach services who may have contact with older HIV-positive people as well as their typical client population.

The ROAH team also recommends more research on the medical and health needs of older HIV-positive people, including them in clinical trials, and implementing curricula in medical and nursing schools that address the specific needs and challenges of older people with the virus.

Video: Columbia University report on seniors with HIV

Barbara Hesselgrave
Barbara Hesselgrave is a freelance writer in Virginia specializing in issues of community medicine, science and international health.

More From Barbara Hesselgrave

A weekly roundup of the best of Pacific Standard and PSmag.com, delivered straight to your inbox.

Recent Posts

December 26 • 2:00 PM

Instead of Re-Drawing the Map, Let’s Transform Our Borders

With borders around the world constantly in dispute, it’s easy to think that the solution might be simple. But it’s time we focus on transforming how we think about borders, rather than simply re-drawing them.


December 26 • 12:13 PM

How Trustworthy Is Published Science?

There’s some evidence of a reproducibility problem. But the more recent emphasis on exact replication of experiments may be misguided.


December 26 • 12:00 PM

The Few Pardons of President Obama

The president’s commutations put him ahead of recent presidents but his use of pardons still lags behind Ronald Reagan, George H.W. Bush, Bill Clinton, and George W. Bush.


December 26 • 10:00 AM

5 Technology Trends to Watch Out for in 2015

Next year may finally be the year we stop using cash completely and leave the large social networks we’ve grown accustomed to behind (think Facebook and Twitter) as we seek out safer alternatives.


December 26 • 8:00 AM

Problems With Police Sanctions

Recent research about ways to deal with police misconduct, and some of its unintended consequences.


December 26 • 6:00 AM

Let Them Eat Quiche: How the Local Food Movement Swerved Right

The quest to localize fresh food is as much an anti-big-ag endeavor as it is an anti-regulatory one.


December 26 • 4:00 AM

The Mythology of Uniqueness

Places, like people, thrive on a self-perception of exceptionalism.


December 24 • 2:00 PM

Retiring a National Crisis

We’re in the middle of a national retirement savings crisis, and as more businesses fail to offer retirement savings options, it will only get worse. How can we reverse this trend? Illinois might have a solution.


December 24 • 12:00 PM

Ignoring One of the Big Problems With Charter Schools

A top official in the New York State Comptroller’s Office has urged regulators to require more transparency on charter-school finances. The response has been, well, non-existent.


December 24 • 10:00 AM

The Cookies of Christmas Past

Grandma’s recipes are always better than Martha Stewart’s.


December 24 • 8:00 AM

Digital Culture: Inside the Subreddit Obsessed With Solving the ‘Serial’ Case

Hamilton Verissimo, a software engineer from New Zealand, joined Reddit just to participate in Serialpodcast, a virtual home for tens of thousands of subscribers with theories and interpretations about the hit podcast.



December 24 • 6:00 AM

A Jewish Christmas

Chinese food, movies, and the assertion of an identity.


December 24 • 4:00 AM

We Need to Get Better at Password Protection

This whole Sony hack should teach us, above all else, a lesson on password security.



December 23 • 2:00 PM

The Paternity Leave Stimulus

Some policymakers (and most recently a Brazilian mayor) have argued that paternity leave policies would disrupt economic productivity. Quite the opposite, actually. In fact, it’s a policy that can boost economies, empower women, and make families happier.


December 23 • 12:00 PM

Why New York State Just Banned Fracking—and Why Others May Soon Follow

After years of delays and debate, Governor Andrew Cuomo decides that the risks outweigh the rewards.


December 23 • 9:40 AM

A Brief History of the Christmas Controversy

Can Christmas’ pagan roots explain its increasing secularization today?


December 23 • 8:00 AM

On Cuba and Baseball Capitalism

After a long wait, a Cuba-to-United States baseball pipeline appears to be on the horizon. That’s a good thing, right?


December 23 • 7:06 AM

Coming Soon: 5 Ways to Understand ISIS


December 23 • 6:00 AM

The Puzzle of the Written Word

In his new book, A Muse & A Maze: Writing as Puzzle, Mystery, and Magic, Peter Turchi explains the riddling experience of literature.


December 23 • 4:06 AM

Most Diabetic Seniors Think Health Tracking Apps Are a Good Idea

But almost none of them actually use apps to help manage their diabetes.


December 22 • 2:00 PM

The Paradox of Women’s Sexuality in Breastfeeding Advocacy and Breast Cancer Campaigns

We capitalize on the sexualization of the breast to raise awareness about breast cancer, yet we cringe at the idea of a woman nursing her child.


December 22 • 1:00 PM

Keep That E-Reader Out of Bed and You’ll Feel Better in the Morning

New research finds e-readers, like other light-emitting electronic devices, can disrupt normal sleep patterns.


December 22 • 12:25 PM

Stop Trying to Be the ‘Next Silicon Valley’

American cities often try to mimic their more economically successful counterparts. A new study suggests that it’s time to stop.


Follow us


We Need to Get Better at Password Protection

This whole Sony hack should teach us, above all else, a lesson on password security.

Most Diabetic Seniors Think Health Tracking Apps Are a Good Idea

But almost none of them actually use apps to help manage their diabetes.

Stop Trying to Be the ‘Next Silicon Valley’

American cities often try to mimic their more economically successful counterparts. A new study suggests that it's time to stop.

Don’t Text and Drive—Especially If You’re Old

A new study shows that texting while driving becomes even more dangerous with age.

The Big One

One in two United States senators and two in five House members who left office between 1998 and 2004 became lobbyists. November/December 2014

Copyright © 2014 by Pacific Standard and The Miller-McCune Center for Research, Media, and Public Policy. All Rights Reserved.