Broaching a Delicate Subject: HIV and other STDs among the middle aged and elderly


Far too many people in my age bracket (middle age) and older are too little concerned about practicing "safer sex." While much attention (though not nearly enough) has been given to educating our youth on the subject, their parents and grandparents apparently either don't know enough or don't act on what they do know.


Far too many people in my age bracket and older are too little concerned about practicing "safer sex." While much attention (though not nearly enough) has been given to educating our youth on the subject, their parents and grandparents apparently either don't know enough or don't act on what they do know.

Today I came across an article on the Women's e-news newswire about the vulnerability of post-menopausal women to HIV, and the dramatic increase in the number of women over age 50 who have been infected. The article states: "The Atlanta-based Centers for Disease Control and Prevention reports that AIDS cases among Americans over 50 have quintupled since 1995, up from 16,300 in 1995 to 90,600 in 2003. Today, seniors represent an estimated 14 percent of total AIDS cases and senior women represent 18 percent of female AIDS cases."

According to the article, post-menopausal women are particularly vulnerable to HIV because of physiological changes:

"Menopause can lead to vaginal dryness, contributing to abrasions and small tears during sex that boost the chance of HIV transmission. With weight loss, fatigue, skin rashes and other HIV symptoms mimicking those of old age, many older women are not diagnosed until they have full-blown AIDS.

"With their immune systems compromised by age, older women can have trouble fighting off pneumonia and other secondary infections. Since many have been socialized to think of sex as embarrassing or secretive, many are reticent about their condition. This puts them in greater jeopardy because they are less likely to be coaxed and prodded by friends and family into treatment."

Although not addressed by the article, the very same elements that increase vulnerability to HIV among post-menopausal women also mean increased vulnerability to other STD's. While HIV is the one people fear the most, another disease -- hepatitis -- if left untreated can also be deadly and is the most common cause of the need for liver transplants. As with HIV, it is possible to have hepatitis without showing any symptoms for a very long time after initial infection. There are a number of other STD's that people can carry and transmit without ever showing any symptoms. Also, the presence of another, more minor STD (such as herpes or genital warts) increases the odds of becoming infected with HIV or hepatitis.

According to the Center for Disease Control "Approximately 20 million people are currently infected with HPV. At least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives. By age 50, at least 80 percent of women will have acquired genital HPV infection. About 5.5 million Americans get a new genital HPV infection each year."

HPV is of particular concern for women because "persistent infection with 'high-risk' types of HPV is the main risk factor for cervical cancer."

I urge everyone to fully inform themselves about STD's, how to prevent them (even consistent condom use is not always sufficient), and when and how often they should be tested. A lot of mature adults think they already know everything they need to know, but most really don't. And even those who do know most of the facts often don't comprehend the risk in a way that significantly alters their behavior.

As the Women's e-News article makes clear, age does not protect you, and in fact makes you even more vulnerable than your children or grandchildren.

A place to start is at the website sponsored by Planned Parenthood of the Rochester Syracuse Region. I was responsible for gathering and editing most of the reproductive health information that is published there. Other good sources of information are The American Social Health Association and the Center for Disease Control section on sexually transmitted diseases.

Posted: Tue - March 16, 2004 at 09:24 AM          

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