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AIDS Management

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The Graying of the AIDS Epidemic

By Liza Berger, Staff Writer

(Page 2 of 3)

But health officials and doctors have not effectively communicated the message. Little HIV prevention education is targeted at older people. Most older people do not receive training in safer sexual activities. Because older people don’t see themselves on posters or billboards advertising AIDS prevention, they may think they are immune to the illness, Taylor of SAGE said. Society itself has a blind spot when it comes to thinking about older people contracting HIV. “We don’t tend to think of older adults as sexual people and don’t tend to think of them as using recreational drugs,” she said.
 
The reality is that because people are living longer, they are engaging in sex until a later age. Viagra and other sexual enhancement drugs may contribute to increased rates of sexual activity. Also, physicians may not diagnose HIV infection in older people, or inquire about their sexual habits or drug use, or talk to them about risky behaviors. Moreover, doctors may overlook early symptoms of HIV as normal signs of aging.
 
Aging with HIV
 
The aging process tends to complicate the effects of HIV. While older adults tend to adhere to drug regimens better than younger people, the side effects can be more severe, researcher Gebo said. Renal failure is more likely to happen in the elderly. Metabolism of the drugs is affected by worsening kidney and liver function with aging, she added.Complications from a variety of drugs also appear to be a major problem. Medicines for age-related conditions, such as heart disease, depression, osteoporosis and diabetes, may interfere with strong ARVs, which are used to treat HIV.
 
Dementia is another problem that older people with HIV or AIDS are facing. While older people tend to develop cognitive problems, ARVs may worsen them. Moreover, many other health problems older people face, such as osteoporosis, may progress faster in people with HIV.
 
Other “hidden” illnesses, such as depression and loneliness, are common in older adults with HIV. Because of the stigma attached to HIV and AIDS, they may feel they can’t tell their families and friends about their illness. (“What will the people in church think?”) Some may stop seeing their grandchildren. While there are advocacy groups for older adults, this cohort may shy away from joining support groups. Depression, while a problem in younger people, can lead to other health problems and have more detrimental effects in older adults.
 
Financial Stress
  
Financial problems among this population also cannot be overlooked, according to Gebo. Under Medicare Part D, the government program that pays for Medicare prescription drugs, there is a coverage limit at which the government will stop paying for drugs annually. That threshold is $2,250. When Medicare recipients reach this level in drug costs, they are responsible for the total cost of their formulary expenses—until they reach $5,100 in total spending. Many older adults with HIV must seek other sources of funding, such as the Ryan White CARE Act, that provide assistance to cover this gap.

 

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