HIV began mostly as a disease of young men, but today the epidemic impacts people of all ages, including older people (age 50 and over). While most new HIV infections are still in younger people, people 50 and older are also being infected.

Women over 50 are frequently ignored in discussions about HIV prevention and care. It is important that this changes. Older women, their health care and social services providers, and their families need to understand how the virus can and does impact this senior age group.

• About 10 percent of AIDS cases in the US female population are in women older than 50, with women of color representing the largest portion. The number of AIDS cases in aging women has increased nearly three times in the last 10 years, and heterosexual HIV transmission rates among women older than 50 may have doubled.
• Despite the myth that older people don’t have sex, many senior women are sexually active and some are injection-drug users. Older women can actually be at greater risk for HIV infection then younger women with the same behaviors because they have thinner vaginal walls and other changes in their bodies.
• The number of 55-to-64-year-old single people in the US increased about 1.5 million in the late 1990s. Most of these people were women. If you are in this group and are thinking about dating, you need to be aware that age does not protect you from HIV or other sexually transmitted diseases (STDs).
• Older HIV+ women usually are invisible and isolated, keeping their disease secret from friends and even family. They are afraid to admit they have HIV because of the stigma.
• Due to the lack of awareness of HIV in the older population (women in particular), this age group has been left out of educational prevention programs, research, and clinical trials.
• Older individuals are not routinely tested for HIV. This means that older women are often misdiagnosed and/or not diagnosed with the virus until they have reached a late stage of HIV disease.

It is important to prevent new HIV infections in older people by educating them about the need for routine HIV testing and early diagnosis; how the virus is transmitted; behaviors that place them at risk; and strategies, such as condom use and needle exchange, that can reduce their risk.

However, we don’t usually see the face of a senior citizen on HIV prevention posters – older people are often a forgotten audience for informational programs. As a result, they may miss out on opportunities to understand the basics of HIV transmission.

In addition, older people often believe that they are not at risk for HIV because of their age. Like younger people, older people can get HIV from unprotected sex and from sharing needles, even needles only used for insulin shots.

• Women who have gone through menopause often don’t think about condoms because they do not need them for birth control. However, condoms can prevent STD transmission at any age. It is best for couples to discuss “safe sex” before passions affect good judgment. (See TWP info sheet called Negotiating for Condom Use)
• Remember that no one can be totally sure about the sexual or drug history of anyone else. A person could be unaware that their new or old partner (a lover, a spouse) has sex with other people. A partner could also be secretly injecting drugs and sharing needles.
• For aging women, there is another consideration. Vaginal walls become thinner and can tear more easily and there is a decrease in the fluids that lubricate. This can put an older woman at higher risk during unprotected sex.
• Health care and social service providers need to recognize and accept that their aging patients and clients are at risk for HIV. It is important for providers to ask older patients about their sexual and drug histories. Providers can offer information on HIV transmission and prevention and suggest HIV testing. The Centers for Disease Control (CDC) recommends routine HIV testing for all adults up to age 64. The CDC also recommends HIV testing every year for adults 64 and over who have risk factors for HIV (having unsafe sex, using injection drugs).

If you may have been exposed to HIV, no matter what your age, look into HIV testing. You have a better chance of staying well if you are diagnosed sooner and get good medical care. If infected, you do not have to give in to the virus, or give up. If you have a good attitude and take care of yourself, you may be able to live with HIV as a chronic disease, well into old age. And if you are negative, you can learn what precautions you need to take to stay that way.