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  Fact Sheet
25
HIV and the Older Person

This Fact Sheet explores issues surrounding HIV/AIDS and the Older Person, including Sexuality and IV Drug Use in Older Adults, HIV and the Aging Process, HIV and Mature Women, HAART and Osteoporosis, Protease Inhibitors and Viagra, and Vitamin B12 Deficiency and HIV.

Fact Sheet #25 is one of an on-going series. Visit the catalogue of Briefing Documents and Fact Sheets.

Go to the related Briefing Document.

The Fact Sheets are created by AIDS Calgary Awareness Association

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HIV/AIDS and Older Persons

Increasing numbers of older persons (defined for our purposes as ages 50 and up) are living with HIV and AIDS. More effective medications are extending lifespan and infections are occurring later in life. Unfortunately, research and prevention efforts have been scarce among older populations. Thus, health professionals, researchers, and educators must re-evaluate how they serve older adults regarding HIV and AIDS information, services, and treatment.

Facts and Figures

  1. Ten percent of people living with HIV and AIDS in southern Alberta are over the age of 50.
  2. From 1995 to 1999, just under 10% of men and 5% of women testing positive for HIV in Canada were 50 years of age or older.
  3. Persons 50 and over represent 11.2% of the total number of reported AIDS cases in Canada between 1995 and 1999

Sex and the Single Senior

Contrary to popular belief, sexuality does not disappear at mid-life or menopause. Unfortunately, condom use is quite low among older adults. Heterosexuals over 50 who exhibit high risk activities are one-sixth as likely to use condoms during vaginal or anal sex and one-fifth as likely to be tested for HIV as are comparable individuals in their twenties.

IV Drug Use among Older Adults

It is often assumed that drug users ‘age out’ of their addiction, either because they managed to conquer their addiction, or because they died from their drug use. Another stereotype is that older adults would not begin using IV drugs ‘at their age’. This is not so, particularly due to the link between sex and drug use encountered by older men dating younger, drug-using women, or vice versa.

HIV Symptoms and the Aging Process

Symptoms like dementia, lung problems, and unexplained weight loss, are often attributed to the aging process instead of being investigated as HIV related. Forty percent of primary-care physicians report rarely or never asking patients over 50 about HIV risk factors, while only 7 percent do not ask patients under 30.

HIV and Mature Women

Physical concerns specific to older women often centre around symptoms and interactions with menopause. Very little research was found on the interactions of HIV drugs with the medications commonly used by aging women. With regard to sexuality, older, post-menopausal women are at greater risk of HIV infection through sexual activity due to thinning vaginal walls and reduced lubrication. Menopause is also linked in many women to weight gain, made more difficult with the use of protease inhibitors which can cause lipodystrophy (body fat redistribution).

HAART and Osteoporosis

Highly active antiretroviral therapy (HAART) has been associated with a number of side effects, such as kidney stones, nausea, and lipodystrophy. However, a more recently discovered side effect is clearly increased levels of bone mineral density loss among men aged 26-50 on HAART. This loss of bone density can lead to osteoporosis, a condition whereby bones become extremely brittle and more easily chip or break.

Protease Inhibitors and Viagra

Viagra, a sexual dysfunction treatment used predominantly, though not exclusively by older men, appears to have the potential to interact with protease inhibitors. Viagra is metabolized in the liver by the same enzymes which are inhibited by protease inhibitors. This can result in increased levels of Viagra in the bloodstream which can in turn lead to headaches, flushing, and sudden, severe fall in blood pressure.

B12 Deficiency and HIV

B12 levels may drop in older adults as a result of decreased stomach acid levels. The same condition can arise due to HIV infection. B12 deficiency can lead to fatigue, depression, increased risk of heart disease and stroke, and possibly osteoporosis and Alzheimer’s disease. Of primary concern, however, is the link between vitamin B12 deficiency and rapid HIV disease progression. In these cases B12 supplementation by injection is recommended.

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