April 05, 2020

Older people overlooked as part of AIDS epidemic

ATLANTA — Between 1991 and 1996, new AIDS cases rose twice as fast among older people as they did among young adults, the government said Thursday.

That suggests that older adults may not be protecting themselves against the disease and that their doctors aren’t look for it, the Centers for Disease Control and Prevention said.

In 1996, 6,400 AIDS cases were diagnosed in the United States among people 50 and older, up 22 percent from 5,260 new cases in 1991, the CDC said.

New AIDS cases for the 13-to-49 age group rose 9 percent in the same period, from 46,000 cases to 50,300.

The CDC said most older adults who got AIDS in the early days of the epidemic probably contracted it from a tainted blood transfusion. Now, more are being infected by unprotected sex and injecting drugs.

“These are older adults who are engaging in some risky behaviors because they don’t perceive themselves to be at risk,” said Dr. Kimberly Holding of the CDC.

Among older women, the number of new AIDS cases linked to unprotected sex more than doubled between 1991 and 1996 — from 340 to 700. In older men, that increase was almost as sharp — from 360 to 700.

New cases among older men who inject drugs jumped 53 percent, from 850 to 1,300. Among older women, the increase was 75 percent, from 160 to 280.

“People in this age group are worried about their heart, their prostate, their lungs,” said Dr. Jerome Groopman, a Boston doctor who cares for about 10 older AIDS patients. “They don’t think of this. The bottom line is that this virus does not discriminate.”

Doctors may be less likely to consider the possibility of HIV infection among older adults, so they don’t counsel them on the risks or discuss protection, the CDC said.

Diseases that signal an AIDS infection often mimic the illnesses of aging, Ms. Holding said. For example, dementia associated with HIV could be misread as Alzheimer’s disease, and dramatic weight loss could be mistaken for age-related depression.

That means that when older people are diagnosed with AIDS, it’s more often in the later stages.

In 1996, 13 percent of people 50 and older died within a month of their AIDS diagnosis, compared with 6 percent of those between 13 and 49.

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