Newly Diagnosed: Older Adults

First Things First

If you have just been diagnosed with HIV, it’s important to find an HIV care provider, even if you don’t feel sick. Your HIV care provider will be the person who partners with you to manage your HIV. He or she will monitor your health on an ongoing basis and work with you to develop a treatment plan.

It’s never too early to start treatment. Current guidelines recommend treatment with ART for all people with HIV, including those over 50 years old or those with early infection. If you don’t have a regular doctor, your HIV testing location or your local health department can help you find an HIV care provider. Or, you can use the AIDS.gov HIV Testing and Care Services Locator to find a provider near you.

You should also learn about the steps you can to avoid transmitting HIV to anyone else. Visit our page, Newly Diagnosed: What You Need to Know to learn what steps you need to take to manage your infection and prevent passing HIV to others.

Newly Diagnosed: People Over 50

If you have just been diagnosed with HIV, you may have many questions about what HIV is and how you will manage your HIV disease. If so, please see our page Newly Diagnosed: What You Need to Know.

The most important thing to know is that HIV is a manageable disease. There is no cure. HIV is a serious, infectious disease that can lead to death if it isn't treated. But there is good news: people who are diagnosed early in their infection, and who get and stay on antiretroviral therapy (ART) can keep the virus under control, and live a long and healthy life.

At the same time, if you are over the age of 50, there are some important considerations to keep in mind:

• Treating HIV can be more challenging as you age because you may have other medical problems that require medication and treatment. You will need to work closely with your healthcare providers to choose medications with the least chance of harmful interactions.
• HIV appears to increase the risk for age-associated diseases, as well as to cause chronic inflammation, which, in turn, is associated with a number of health conditions.
• Your care may involve multiple providers who treat older adults for a variety of different physical and mental health needs.
• Many older adults already experience feelings of isolation, due to illness or loss of family and friends over time. Having a diagnosis of HIV can increase that sense of isolation, especially if your family and friends are unaware of your status.
• HIV stigma is also a particular concern among older adults and can create barriers to the medical and social services that people with HIV need. Stigma negatively affects a person’s quality of life, self-image, and behaviors, which may prevent some individuals from seeking HIV care or remaining engaged in care.

In addition, older Americans are more likely than younger Americans to be diagnosed with HIV infection late in the course of their disease, meaning they get a late start to treatment after, possibly, more damage has occurred to their immune system. Being diagnosed late in your infection can lead to poorer health outcomes and shorter survival after an HIV diagnosis.

For more information, see our page, Aging with HIV/AIDS.

Older People and HIV Risk

It is also important to know that you are not alone. A growing number of people aged 50 and older in the United States are living with HIV infection. According to CDC, people aged 55 and older accounted for over one-quarter (26%, 313,200) of the estimated 1.2 million people living with HIV infection in the United States in 2011.

Many older people are sexually active, and have many of the same risk factors for HIV infection as younger people, including a lack of knowledge about HIV and how to prevent it, and multiple partners. Older people also face unique issues, including:

• Many widowed and divorced people are dating again, and they may be less knowledgeable about HIV than younger people, and less likely to protect themselves.
• Women who no longer worry about getting pregnant may be less likely to use a condom and to practice safer sex. Age-related thinning and dryness of vaginal tissue may raise older women’s risk for HIV infection.
• The availability of erectile dysfunction medications may facilitate sex for older men who otherwise would not have been capable of vaginal or anal intercourse.
• Although they visit their doctors more frequently, older people are less likely than younger people to discuss their sexual habits or drug use with their doctors, who in turn may be less likely to ask their older patients about these issues.

When older adults have insufficient information about HIV transmission, the risks associated with the factors above are intensified.

In addition, many older people may have HIV and not know it. Older people are less likely than younger people to get tested. Signs of HIV/AIDS can be mistaken for the aches and pains of normal aging. Older adults might be coping with other diseases common to aging that can mask the signs of HIV/AIDS.

Also, some older people may be ashamed or afraid to seek HIV testing. Plus, healthcare providers do not always think to test older people for HIV/AIDS. By the time the older person is diagnosed, the virus may be in the late stages and more likely to progress to AIDS.

Remember, it is important to get tested for HIV/AIDS early. Early treatment may help prevent HIV from progressing to AIDS. Visit the AIDS.gov HIV Testing and Care Services Locator to find a testing site near you.

For more information, see NIA’s HIV, AIDS, and Older People.