HIV Over 50

Editor's Note: The following story is taken from a talk given at the National AIDS Update Conference in San Francisco in March, held by the American Foundation for AIDS Research (amfAR).

There was an earlier time when my name and the topic of HIV were proposed to a group of medical providers organizing a "senior" health symposium. I and my topic were promptly rejected by the program planners because, they asserted, "Old people don't need to hear about AIDS."

Wrong. They do need to hear that HIV can infect and affect older individuals. We all need to understand that between 10 and 15 percent of AIDS cases in the United States are in persons over 50 years of age.

HIV/AIDS is often not acknowledged in the aging community because of the common perception that older adults are no longer sexually active and, therefore, are not at risk for infection. This results in a lack of prevention programs targeted at older individuals and in the failure of health care and service providers to discuss matters of sexuality -- or drug use, for that matter -- with aging patients and clients.

For example, I recently asked a thirty-something gynecologist if she routinely took sexual histories of older women. "Oh, no, I wouldn't be comfortable in doing that," she answered. I suggested it is important that she overcome her reluctance.

HIV-infected elders are frequently invisible, isolated and ignored, due to the dual stigma of living with a sexually-transmitted disease and of being "old," a condition that in our U.S. culture is often not valued or respected. The dual stigma makes it especially difficult for seniors to disclose to family and friends, thereby forfeiting support that might be forthcoming.

I'm still seeking acknowledgment of HIV/AIDS in the aging community. I've been doing this work for five years. I don't do it because I adopted this cause out of the goodness of my heart. I do this work because I hope I can make a difference. It's because of a letter I opened on a Sunday in January in 1991. A health insurance company to which I had applied for new medical coverage announced that I had been rejected because of a "significant blood abnormality."

Distraught to discover that I apparently was suffering from a serious blood disorder, I slept little that night; the next morning, I telephoned the insurance underwriter. "What is this 'significant blood abnormality,'" I inquired. Her reply: "I'm sorry but that's confidential. Your doctor will have to tell you."

A few hours later, I was in the office of my family practitioner, who looked troubled as she referred to a fax and reported, "Jane, this insurance company claims your blood tested positive for HIV." Stunned, I had a second test two days later. After waiting two weeks -- the longest two weeks of my life -- I learned, sadly, that I do have the virus that causes AIDS.