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HIV Among People Aged 50 and Over

Fast Facts

  • People aged 55 and older accounted for 26% of all Americans living with diagnosed or undiagnosed HIV infection in 2013.
  • People aged 50 and older have the same HIV risk factors as younger people, but may be less aware of their HIV risk factors.
  • Older Americans are more likely to be diagnosed with HIV infection later in the course of their disease.

	photo of an older couple on a couchIn 2013, people aged 55 and older accounted for more than one-quarter (26%, or 319,900) of the estimated 1.2 million people living with diagnosed or undiagnosed HIV infection in the United States.

The Numbers

HIV Diagnosesa

  • In 2014, people aged 50 and over accounted for 17% (7,391) of an estimated 44,073 HIV diagnoses in the United States. Of these 7,391, the largest number (3,242 or 44%) was among those aged 50 to 54.
  • In 2014, blacks/African Americans accounted for an estimated 43% of all diagnoses among people aged 50 and over. Whites accounted for 37%, and Hispanics/Latinosb accounted for 16%.
  • In 2014, 40% of people aged 55 and older were diagnosed with AIDS at the time of HIV diagnosis (i.e., diagnosed late in the course of the infection).

Estimated Diagnoses of HIV Infection by Age, 2014, United States

	Bar chart shows the estimated diagnoses of HIV infection by age in the United States (2014). Under 13= 174, 13-14=35, 15-19=1,828, 20-24=7,868, 30-34=6,026, 35-39=4,662, 40-44=4,196, 45-49=4,021, 50-54=3,242, 55-59=2,166, 60-64=1,069, 65 and Older=914

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2014. HIV Surveillance Report 2015;26.

Living With HIV and Deaths

  • In 2013, an estimated 42% of Americans living with diagnosed HIV were aged 50 and older, 25% were aged 55 and older, and 6% were aged 65 and older.
  • Among people aged 55 and older who were diagnosed with HIV in 2014, 88% were linked to care within 3 months.c
  • Among people aged 55 and older diagnosed with HIV in 2012 or earlier and alive at the end of 2013, 58% were retained in HIV care, and 58% had a suppressed viral load.c
  • Of the 6,721 deaths from HIV in 2014, 2,610 (39%) were among people aged 55 and older.

Prevention Challenges

Older people in the United States are more likely than younger people to be diagnosed with HIV infection late in the course of the infection, which results in their starting treatment late and possibly suffering more immune-system damage. Late diagnoses can occur because health care providers may not always test older people for HIV infection, and older people may not consider themselves to be at risk of HIV infection or may mistake HIV symptoms for those of normal aging and not consider HIV as a cause.

Many older people are sexually active, including those living with HIV, and may have the same HIV risk factors as younger people, including a lack of knowledge about HIV and how to prevent getting it, as well as having multiple sex partners. Older people also face some unique issues:

  • Many widowed and divorced people are dating again. They may be less aware of their risks for HIV than younger people, believing HIV is not an issue for older people. Thus, they may be less likely to protect themselves.
  • Women who no longer worry about becoming pregnant may be less likely to use a condom and to practice safer sex. Age-related thinning and dryness of vaginal tissue may raise older women’s risk for HIV infection.
  • Although they visit their doctors more frequently, older people are less likely than younger people to discuss their sexual habits or drug use with their doctors. And doctors are less likely to ask their older patients about these issues.

Stigma is a particular concern among older people because they may already face isolation due to illness or loss of family and friends. Stigma negatively affects people’s quality of life, self-image, and behaviors, and may prevent them from seeking HIV care and disclosing their HIV status.

Aging with HIV infection also presents special challenges for preventing other diseases because both age and HIV increase risk for cardiovascular disease, thin bones, and certain cancers. Older HIV patients and their care providers need to maximize prevention efforts against these conditions and remain vigilant for early signs of illness. They also need to be careful about interactions between the medications used to treat HIV and those used to treat common age-related conditions such as hypertension, diabetes, elevated cholesterol, and obesity.

What CDC Is Doing

	photo of four older people walking on a beachCDC and its partners are working together to advance the goals of the National HIV/AIDS Strategy, maximize the effectiveness of current HIV prevention methods, and improve surveillance among older people in the United States. Activities include

  • Support and technical assistance to health department and community-based organizations to deliver effective prevention and evidence-based interventions for antiretroviral therapy adherence for older Americans.
  • Act Against AIDS, a national communications initiative that focuses on raising awareness, fighting stigma, and reducing the risk of HIV infection among at-risk populations. Act Against AIDS includes Let’s Stop HIV Together (approximately 25% of campaign participants are aged 50 and older); HIV Screening. Standard Care., which encourages primary care physicians to screen patients of all ages for HIV infection; and Prevention IS Care, which provides continuing education and materials for physicians to address the complex issues of those living with HIV infection.
  • Starting in 2012, CDC has awarded at least $330 million each year ($343.7 million in 2015) to health departments to direct resources to the populations and geographic areas of greatest need and prioritize the HIV prevention strategies that will have the greatest impact.

For additional information and resources, visit:

a HIV diagnoses indicate when a person was diagnosed with HIV, not when the person was infected.
b Hispanics/Latinos can be of any race.
c In 32 states and the District of Columbia (the areas with complete lab reporting by December 2015).

Bibliography

  1. CDC. Diagnoses of HIV infection in the United States and dependent areas, 2014. HIV Surveillance Report 2015;26. Accessed July 1, 2016.
  2. CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data: United States and 6 dependent areas, 2014. HIV Surveillance Supplemental Report 2016;21(4). Accessed August 1, 2016.
  3. CDC. National Vital Statistics System. 2014 Multiple Cause of Death Data File. 2014. Accessed July 1, 2016.
  4. CDC. Diagnoses of HIV infection among adults aged 50 years and older in the United States and dependent areas, 2010-2014. HIV Surveillance Supplemental Report 2016;21(2). Accessed July 1, 2016.
  5. Althoff KN, Gebo KA, Gange SJ, et al. CD4 count at presentation for HIV care in the United States and Canada: are those over 50 years more likely to have a delayed presentation? AIDS Res Ther 2010;7:45.
  6. Brooks JT, Buchacz K, Gebo KA, Mermin J. HIV infection and older Americans: the public health perspective. Am J Public Health 2012;102(8):1516-26.
  7. National Institute on Aging. Age Page: HIV, AIDS, and older people. Bethesda, MD: National Institutes of Health; 2016. Accessed July 1, 2016.
  8. Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med 2007;357(8):762-74.
  9. Onen NF, Shacham E, Stamm KE, Overton ET. Comparisons of sexual behaviors and STD prevalence among older and younger individuals with HIV infection. AIDS Care 2010;22(6):711-17. PubMed abstract.
  10. Foster PP, Gaskins SW. Older African Americans’ management of HIV/AIDS stigma. AIDS Care 2009;21(10):1306-12. PubMed abstract.
  11. Golub SA, Tomassilli JC, Pantalone DW, Brennan M, Karpiak SE, Parsons JT. Prevalence and correlates of sexual behavior and risk management among HIV-positive adults over 50. Sex Transm Dis 2010;37(10):615-20. PubMed abstract.
  12. Emlet CA. “You’re awfully old to have this disease”: experiences of stigma and ageism in adults 50 years and older living with HIV/AIDS. Gerontologist 2006;46(6):781-90.
  13. Glaude-Hosch JA, Smith ML, Heckman TG, Miles TP, Olubajo BA, Ory MG. Sexual behaviors, healthcare interactions, and HIV-related perceptions among adults age 60 years and older: an investigation by race/ethnicity. Curr HIV Res 2015;13(5):359-68. PubMed abstract.

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