Africa: Why HIV Risks Are Rising in Older Adults

By Melody Chironda

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Munich, Germany — More and more older people are living with HIV and AIDS.

"While many people were diagnosed with HIV in their youth, new cases are increasingly emerging among older adults," said Dr. Gloria Chepngeno-Langat at the 25th International AIDS Conference in Munich, Germany.

Dr. Chepngeno-Langat, a researcher with a focus on aging and HIV over the past 10 to 15 years said that there is a need to challenge misconceptions about the sexual activity of older adults.

"Often, there is a belief that older individuals are not sexually active and, therefore, do not need interventions or services. This misconception can lead to a lack of necessary resources and increased risk of infections, including HIV and other sexually transmitted infections, among older adults," she said. "This can leave them vulnerable to contracting HIV and other sexually transmitted infections (STIs) even later in life."

Many older adults mistake the symptoms of HIV/AIDS for those associated with natural aging. They are often mistaken for normal aches and pains. Long-term HIV infections can lead to dementia, cardiovascular disease, osteoporosis, diabetes, kidney disease, frailty, and some types of cancer in older people.

In HIV and AIDS programming, people aged 50 and older are categorized as older adults, unlike other sectors where the retirement age is usually 60. This lower threshold is set to address the unique challenges faced by this demographic.

There is very little evidence-based information available on sex and aging. This leaves older adults vulnerable to social isolation and poor quality of life.

"One reason for this is that the focus on HIV/AIDS care and treatment has traditionally been on people of reproductive age. Programs were designed to cater primarily to individuals up to their 40s, leading to the neglect of older adults," she said.

However, the landscape is changing.

Currently, nearly eight million people aged 50 and older are living with HIV globally, representing about 20% of the total HIV-positive population. Most of these individuals reside in Eastern and Southern Africa, regions that have been both the epicenter of the epidemic and of the aging HIV-positive population.

The conversation around HIV and aging extends beyond those diagnosed young and living longer.

"An emerging issue is the increasing rate of infections among older age groups, including sexually transmitted infections (STIs). This trend, which was not evident 10 years ago, is rising due to changing lifestyles, re-partnering, and sexual activity later in life," said Dr. Chepngeno-Langat.

So why should we care?

"Sexuality is a central aspect of being human throughout the lifetime," said Dr. Chepngeno-Langat. "However, our perceptions and expectations of sexuality are shaped by cultural and societal influences, which affect the attitudes and beliefs we develop."

"The rules, regulations, and beliefs surrounding sexuality often involve complex power dynamics and gender issues. For older adults, this creates a particularly challenging situation," she added.

"The intersection of age, gender, and HIV forms a "triple jeopardy" that compounds their difficulties. Therefore, it is crucial to address and dismantle these barriers to ensure that older people receive the support and respect they deserve in matters of sexuality and health," she said. "There is a prevalent misconception that the sexuality of older people is not important, which leads to negative stereotypes. It becomes crucial when we tackle issues of sexual health, sexual rights, sexual health knowledge, information, and prevention among the older population."

So why should we care?

Reflecting on the significance of the 25th AIDS conference, Dr. Chepngeno-Langat said, "This milestone represents 25 years of progress which is significant."

"Considering the history of HIV, which emerged in 1984, we've seen 40 years pass. Over these four decades, substantial efforts have been made to improve the lives of those affected by HIV, enabling many to live healthier and longer lives. In these 40 years, significant milestones include the establishment of the Global Fund for AIDS in 2002, the U.S. Presidential Emergency Plan for AIDS Relief (PEPFAR), and the U.S. Global Health Initiative. These initiatives have played crucial roles in the progress we've made and highlight why this particular session is so relevant today."

Several important initiatives have been introduced over the years such as the "3 by 5 Initiative," which aimed to provide treatment to three million people by 2005, and the "90-90-90" targets, which focused on testing, treatment, and viral suppression. The next goal, "10-10-10," addresses stigma, discrimination, gender inequality, and violence.

"By taking stock of our progress, it is important to look at the sexual and HIV prevention needs of older people," Dr. Chepngeno-Langat said.