Sep 18, 2020
September 18 is National HIV/AIDS and Aging Awareness Day—a day to call attention to the growing number of people living long and full lives with HIV and to aging-related challenges of HIV prevention, testing, treatment, and care.
While we’ve all heard about HIV and AIDS, we might not know what exactly the terms mean.
- HIV (Human Immunodeficiency Virus) is a virus that compromises the immune system.
- A person who is HIV-positive can develop an opportunistic infection, which can lead to the development of AIDS (Acquired Immune Deficiency Syndrome).
- When the body becomes infected, initially, antibodies against HIV begin to form between 6-12 weeks.
- The time between when a person may have been exposed to HIV and when a test can tell for sure whether they have the virus is called the window period. During the window period, flu-like symptoms can occur, including fever, rash, muscle aches and swollen lymph nodes and glands, as well as unexplained weight loss, bruising, and chronic diarrhea.
- Without treatment, HIV usually progresses to AIDS between 8-12 years after infection with HIV.
- With treatment, symptoms may not be present for 15 years or longer.
- PEP (post-exposure prophylaxis) means taking antiretroviral medicines (ART) after being potentially exposed to HIV to prevent becoming infected. PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV. A person who may have been exposed to HIV during sex or through sharing needles and/or works to prepare drugs should talk to a health care provider or an emergency room doctor about PEP right away.
People with HIV are living longer thanks to advances in treatment. According to the Centers for Disease Control and Prevention (CDC), an estimated 47% of people in the United States with diagnosed HIV were aged 50 and older in 2018. In addition, 17% of new HIV diagnoses and 71% of deaths of persons diagnosed with HIV were people 50 and older. People aging with HIV can face treatment-related challenges, such as drug interactions between HIV medicines and medicines used for other conditions.
There are also HIV prevention challenges related to aging. For example, although HIV risk factors are similar for all adults, older adults may be less aware of these factors and the importance of testing to detect HIV in its earliest stages. CDC reports that 35% of people aged 55 and older who received an HIV diagnosis in 2016 already had AIDS. Among people aged 55 and older who received an HIV diagnosis, 50% had been living with HIV for 4.5 years before they were diagnosed—the longest diagnosis delay for any age group.
Older people may have many of the same HIV risk factors as younger people, including a lack of knowledge about HIV prevention and sexual risk, such as having unprotected sex and/or multiple sex partners. CDC recommends that everyone 13 to 64 years old get tested for HIV as part of routine health care. Your health care provider may recommend HIV testing if you are over 64 and at risk for HIV.
For several reasons, older people are less likely to get tested for HIV:
- In general, older people are often considered at low risk of getting HIV. For this reason, health care providers may not always think to test older people for HIV.
- Some older people may be embarrassed or afraid to be tested for HIV.
- In older people, signs of HIV may be mistaken for symptoms of aging or of age-related conditions. Consequently, testing to diagnose the condition may not include HIV testing.
- The stigma of HIV/AIDS may be more severe among older persons, leading them to avoid getting tested or hide their diagnosis from family and friends.
For these reasons, HIV is more likely to be diagnosed at an advanced stage in many older people. Diagnosing HIV at a late stage also means a late start to treatment with HIV medicines and possibly more damage to the immune system.
Ask your health care provider whether HIV testing is right for you.