Running head: HIV- THE EPIDEMIC IN ADULTS OVER FIFTY 1

HIV-The Epidemic in Adults Over the Age of Fifty

Delaware Technical Community College

NUR 3330 Population and Community Health

Sherrill Butler Williamson

15 December 2017
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Introduction

This essay explores published studies and/or sources that have been

conducted on the growing epidemic of HIV in the population of individuals over

the age of fifty. The population of people over the age of 50 with HIV poses a

significant health issue in the present day. According to the Center of Disease

Control (CDC), "People aged 50 and over accounted for 17% (6,725) of the 39,513

HIV diagnoses in 2015 in the United States. People aged 50 to 54 accounted for

45% (3,010) of the diagnoses among people aged 50 and over" (Center of Disease

Control (CDC), 2017).

Throughout this assessment analysis, one will be enlightened on the barriers,

resources, and the need for options and access to healthcare education for the very

vulnerable population of people aged 50 and up diagnosed with HIV.

Barriers

Individuals over the age of fifty are confronted with many barriers that

increases their risk for HIV. Many individuals over the age of fifty are re-entering

the dating scene and have multiple sex partners due to the increase in divorce rates
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and becoming widowed. Many are not as aware of the risk of HIV and tend to have

unprotected sexual encounters (CDC. 2017). Research also indicates that many

women who are post-menopausal have this false belief that due to the reduction of

estrogen that reduces vaginal secretions, their risk for contacting sexually

transmitted diseases have also decreased (CDC, 2017). Another factor in this

epidemic is the level of sexual activity taken place with those over the age of fifty.

Studies indicate that people over the age of fifty are 20% more sexually active than

people in their late thirties and forties (CDC,2017). Most older people are not truly

aware of the risks associated with HIV. There was a recent survey of individuals

over the age of fifty, and it concluded that 92% had never used a condom and that

95% were not tested for HIV. That same study indicated that 83.7% of men and

61.6% of women aged 57 to 64 years of age, and 67.0% of men and 39.5% of

women aged 65 to 74 years of age, conveyed that they had multiple sex partners.

There were reports of high-risk sexually behavior Linley, L., Prejean, J., An, Q.,

Chen, M. and Hall, I. (2012).

Not only does HIV affect one’s health, but also their physical appearance.

Author Simone and Applebaum stated that people who are over the age of fifty

with HIV accelerates the aging process. These same individuals are more likely to

have other heath related issues. It’s been proven that the comorbidities are decrease
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in bone density, poor glucose metabolism, liver and kidney disorders, and coronary

artery disease (Simone & Applebaum, 2008). Research also shows that this

population is more likely to have a friable social support system, mainly because

they live alone and rely on friends rather than family to assist in their care. This is

related to the stigmatization that is placed on individuals with HIV (Simone &

Applebaum 2008. Individuals over the age of fifty are usually diagnosed with HIV

when the infection has advanced because health providers do not offer testing. As

stated previously, there is a false belief associated with people over the age of fifty

not being sexually active. They may also be misdiagnosed because some of the

signs and systems of HIV are similar to the signs of aging (CDC, 2017)

S.M.A.R.T Goals/ Nursing Role

As a nurse working in the community, I have a duty and an obligation to

recognize and access the needs for education and awareness in the older

population. By 2020 35% of all governmental funding that is allocated for HIV

education and awareness will be used to inform older adults, and there will be a

30% increase in the number of individuals over age fifty tested for HIV.

Our roles as a nurse is to promote a safe and trusting environment geared towards

healing. With these actions and efforts put in place, it is estimated that by 2020 the

stigma associated with HIV will have decreased by 50% (Goodman, 2010).

Resources
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The epidemic of people over the age of fifty being newly diagnosis with

HIV has perpetuated the increase in governmental resources allocated for the

prevention of HIV in the older population. The CDC and its partners like Ryan

White have teamed up to increase the awareness of current HIV prevention

methods and enhance supervision among all people in the United States. Under the

current budget opportunity, the CDC has allocated $330 million each year to health

departments for direct distribution for HIV prevention programs. The Goal is to

use that money for the HIV/AIDS population with the greatest need. Act Against

AIDS, is a national communication campaign aimed at raising awareness on the

prevention and the stigmatism among HIV populations that are at risk. 25% of the

organization’s funds are allocated towards the education of individuals over the

age of fifty (CDC, 2017).

Many actions have been taken in efforts to tackle this disease head on. The

Affordable Care Act (ACA) is a federal health care policy that was signed into law

by former President Barack Obama in March 2010 that has many mandates

(Savage, Kub & Groves, 2016). The policy offers more low-income families free

and reduced cost health coverage due to the expansion of Medicaid programs, it

offers a healthcare market to the uninsured at a reduced price, and it penalizes

people with a tax if they are not covered (Savage, Kub & Groves, 2016). ACA also

gives all people the ability to have health coverage regardless of their preexisting
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conditions and it avoids annual and lifetime limits on health care coverage

(Arnold-Long, 2014).

Interventions

There is an increasing number of individuals over the age of fifty that are

being diagnosed with HIV. These interventions aim to educate older adults and

healthcare providers about prevention. All healthcare providers should assess each

older adult’s sexual behaviors, offer HIV testing, teach each patient how to use a

condom properly and each patient needs to be aware of the modes of how HIV is

transmitted (Negin, Rozea, & Martiniuk, 2014). Education is needed to prevent the

transmission of HIV, due to the fact that older adults are still sexually active and

majority are having unprotected sex (Linley et. al, 2012). The increase in divorce

and older adults being widowed, increases this vulnerable population. Many of

these adults have been in long marriages and are not aware of the risks (CDC,

2017)

Healthcare providers must present information in a manner that is safe, non-

judgmental, understandable at the older adult’s educational level, while still being

culturally sensitive without personal bias. (Negin, Rozea, & Martiniuk, 2014).

Many older adults choose not to be forthcoming with information about their

sexual relationships which increases the risk of HIV transmission. The stigma that
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follows HIV makes it extremely difficult for older adults to open a conversation

about HIV. Most believe that it is still a homosexual problem (Goodman, 2010).

Evaluation

To demonstrate the effectiveness of the above interventions, a record of all

individuals over the age of fifty that are tested for HIV will be maintained with

quarterly surveillance to assess the number of newly tested adults over fifty.

Patient’s electronic records will indicate that education on HIV transmission and

prevention was performed yearly. HIV is a disease that isn’t going away as of right

now, so as healthcare providers we must teach, explain, explore other protective

measures and provide our infected patients with the best technological

advancements, education, advancement in medicine options and most importantly

support to fight another day.

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References

Centers of Disease Control and Prevention (2017). HIV among people aged 50 and
over. CDC.
Retrieved From http:/www.cdcgov/hiv/group/age/olderamericans/ind ex.html

Goodman, B.K. (2003). HIV and AIDS in people older than 50. Journal of
Gerontological
Nursing 29(4) 18-24

Negin, J., Rozea, A., Martiniuk, A. L. (2014). HIV behavioral interventions

targeted towards
older adults: a systematic review. BMC Public Health 14.
doi:10.1186/1471-2458-14-507

Linley, L., Prejean, J., An, Q., Chen, M. and Hall, I. (2012). Racial/ethnic
disparities in
HIV diagnoses Among persons aged 50 years and older in 37 US states,
2005-2008. Journal of Public Health, 102(8)

Savage, C., Kub, J., & Groves, S. (2016). Public Science and Nursing Practice:
Caring for
Populations. Philadelphia, PA: F. A. Davis Company

Simone, M.J. and Appelbaum, J. (2008). HIV in older adults. Geriatrics 63(12), 6-
12.