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"Growing Older with the Epidemic: Aging and HIV"

New GMHC report reveals HIV increasingly affects older adults; Severe gaps in research and services exposed

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Krishna Stone | 212.367.1016

By 2015, over half of people living with HIV will be over the age of 50

New York, NY — Nearly one-third of people living with HIV in the United States are over the age of fifty, according to a comprehensive report on HIV among older adults released today by GMHC (the Gay Men's Health Crisis). "Growing older with the epidemic: Aging and HIV" provides a striking overview of current knowledge on older adults and HIV.  This population is growing at a startling rate, increasing by over 61% from 2001 to 2007, posing many unknowns and challenges. This groundbreaking report provides a roadmap to understand and address the needs of this burgeoning population of older Americans. 

"Baby boomers are aging into older adulthood, people with HIV are living longer due to anti-retrovirals, and 17% of new HIV infections occur among people over the age of 50," said Marjorie Hill, Ph.D., Chief Executive Officer of GMHC.   "Our society is not prepared for the baby boomer generation as it enters old age. We don't have enough geriatricians to care for the sharply rising number of seniors. We are even less prepared to care for populations with unique health care needs, such as HIV-positive older adults," Hill added.

Growing older with the epidemic signals concerns as we enter uncharted territory.  We do not have the answers to many of the pressing questions which will determine health outcomes for this burgeoning generation of older adults living with HIV," said Sean Cahill, PhD, Managing Director of Public Policy, and co-author of the study. "While longer life spans are the benefit of successful antiretroviral therapy, we lack knowledge on how aging and HIV interact. The process of aging includes the development of multiple medical conditions (comorbidities) such as cancer, liver and kidney failure, arthritis, and depression. In coming years, research must address how these diseases, and the medications to treat them, interact with HIV and HIV treatment," added Cahill.

Growing older with the epidemic examines what we already know about HIV among older adults-demographics and epidemiological trends-and reveals what we do not yet understand-the biological impact of HIV on aging bodies. The report describes the contexts in which older adults with HIV live, and   the social service and healthcare programs designed to care for both older adults and people living with HIV. It concludes  with a comprehensive set of recommendations focused on the widening gaps in scientific knowledge, provision of appropriate services, and necessary changes to public policies addressing HIV and aging.

"As we approach the fourth decade of the HIV epidemic, we know that by 2015 over half of people living with HIV will be 50 years of age or older. Living longer with HIV is a welcome development but one our  nation is not prepared for. However, we can and we must get ready. Through research, education and public policy changes we can take on these issues before they reach emergency proportions," continued Cahill.

Report recommendations provides a unique roadmap to the future

Growing older with the epidemic provides a roadmap to the future with a broad and detailed range of policy recommendations which tackle the critical issues revealed in the report:  gaps in research, service provision, and government support.

Stigma, a thread throughout the findings, is a leading challenge:   One survey finds that 96% of HIV-positive older adults experienced HIV-stigma; 71% also experienced ageism. Increased training in places where older adults receive care, from medical providers, to, geriatric educational programs, from congregate living facilities, to senior center to caregivers is crucial. The needs of LGBT and HIV-positive elders are often overlooked within these environments.   These elders often lack social support systems, (often isolated from family or friends) face stigma and discrimination from service providers, staff, and other seniors.

Sexphobia combined with ageism impacts the experiences of older adults. Currently, older adults experience a near total lack of attention to their sexual health from health care professionals and broad assumptions that they are not sexually active. Medical professionals are hesitant to talk with older adults about sexual health thereby putting at risk the health of older Americans. Combined with research showing that gay and bisexual men of color are less likely to disclose sexual behavior to doctors than white gay men, these findings suggest significant health disparities and implications for HIV among older adults. It is likely that older gay and bisexual men of color disclose to their doctors at the lowest rates. Faced with lack of attention to elder sexual health by medical professionals compounded with likely low disclosure rates, it is probable that older gay and bisexual men of color face significant health disparities and increased risk for HIV. The de-sexualization of older adults also results in policies and practices in senior settings, including residential and social services communities, which deny older adults control over decisions around sexual intimacy and privacy, an experience for LGBT seniors that is often linked to homophobia.

Public policy changes at federal and local are critically needed. Following passage of federal health care reform, the GMHC report defines a public policy agenda addressing the specific needs of HIV-positive older adults.  Federal policy changes could have a significant impact on addressing health disparities among older adults, as well as stigma and discrimination. Designating HIV-positive and LGBT elders as a vulnerable population in the Older Americans Act is an important next step. Additionally, changes are needed in federal laws and policies, including the Family Medical Leave Act, Social Security spousal benefits, and Medicaid regulations, which discriminate against same-sex couples. "Addressing the complexities of aging and HIV is a pressing issue requiring the support and input of a broad range of organizations, policy makers and community leaders," noted Dr. Hill.

"Meeting the pressing demands in this new era of the epidemic is a challenge we can take on, but only if we address the needs revealed in "Growing older with the epidemic," said Lois Aronstein, AARP New York State Director.  "It is an invaluable report, for everyone, from researchers to medical professionals,   from policy makers to older adults aging with HIV. After reading this report, you can't claim in 10 years, we didn't see this problem coming," added Aronstein.

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GMHC is a not-for-profit, volunteer-supported and community-based organization committed to national leadership in the fight against AIDS.  We provide prevention and care services to men, women and families that are living with, or affected by, HIV/AIDS in New York City.  We advocate for scientific, evidence-based public health solutions for hundreds of thousands worldwide.

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