If you’re over 50 and reading this, chances are you know a thing or two about HIV. Unfortunately, not everyone is so well-informed. As people live longer and find themselves single after the breakup of a long-term relationship or a partner’s death, many dive back into the dating pool—with pregnancy worries lessened and drugs like Viagra keeping things interesting. Problem is, many older people aren’t playing safely: One survey found that people over 50 were one-sixth as likely to use condoms and one-fifth as likely to get tested for HIV as people in their twenties. Karpiak’s study found that only one-third of sexually active people over 50 practiced safer sex.
Some docs worsen the problem by buying into stereotypes that their older patients don’t have sex or inject drugs. “Physicians are less likely to ask older patients about high-risk behaviors or suspect HIV,” says Gebo. They also may not be familiar with relevant physiological changes: Menopause causes decreased lubrication and vaginal thinning, putting women at greater risk.
The good news is that after starting HAART, people over 50 can get their viral load under control as well as the youngsters. Most studies show that older people don’t experience as much CD4 cell recovery, probably due to the effects of aging on the immune system. But this isn’t always the case. Since he started HAART, Van Nattan’s CD4s have been on the upswing from a low of 20 and now stand at 600.