Thousands of people 50 and older are diagnosed with HIV each year in the United States, a development that has significant consequences for the health care and social support they need and the doctors, counselors and others who provide it.
Older people tend to be sicker when the infection is finally discovered. They usually have other health conditions that accompany aging and often are too embarrassed to reveal their illness to family and friends.
Many never dreamed they were at risk of contracting the virus, and some have outmoded ideas of a disease that long ago became manageable through advances in medication.
“I said, ‘Well, I guess that’s a death sentence,’ ” a Maryland man recalled of his diagnosis at the age of 73. “And the fellow who told me said: ‘No, it’s not. It’s not like that anymore. Once you get on medication, you’ll probably die of whatever old-age thing you’re going to die of anyway.’”
Yet health-care providers still don’t routinely consider HIV when treating older patients, despite guidelines that call on them to screen through age 64, researchers and physicians say. They may be reluctant to ask about an older person’s sex life and sometimes attribute HIV symptoms to age-related issues such as heart disease.
Amy C. Justice, a researcher at Yale University’s Center for Interdisciplinary Research on AIDS, recalled a married man in his 60s who was seen by specialists at Yale-New Haven Hospital. It took more than 18 months before anyone thought to test him for HIV, despite symptoms consistent with the disease.
In 2014, nearly 17 percent of the country’s new HIV diagnoses — 7,391 of 44,071 — were among people 50 and older, according to the Centers for Disease Control and Prevention. That was down slightly from 2013 but up from 15.4 percent in 2005, when data were less complete.