AIDS Growing Fast
Among US Seniors
By Cynthia Hubert - The Sacramento Bee

SAN FRANCISCO - The newest face of AIDS has wrinkles.
One of the fastest growing categories of people with the disease, which long has been considered a plague of the young, are senior citizens, speakers at a national conference report.
People age 50 and older represent more than 10 percent of AIDS cases in the United States, and their numbers are bound to grow as the epidemic ages and new treatments extend life for people with the disease, researchers and advocates say.
More than 70,000 Americans in that age group have been diagnosed with AIDS and countless others carry the virus that causes the disease, said Massachusetts expert Donna Gallagher.
Between 1991 and 1996, the number of AIDS cases among people 50 and older grew 22 percent, more than twice as fast as among younger adults, Gallagher said.
Yet until recently, older patients with AIDS or the HIV virus that causes it received little attention from the medical community.
Elders infected by HIV are frequently invisible and largely ignored,'' said Jane Fowler, founder of a national AIDS advocacy group focusing on older patients.
Fowler speaks from personal experience: Nine years ago, at age 55, the former journalist learned after applying for life insurance that her blood tested positive for HIV. Fowler, divorced at the time, said she was exposed to the virus through sexual contact with ''an old friend'' she had been dating.
''I never dreamed it would happen to me,'' she said. ''I didn't fit the HIV and AIDS stereotype.''
After years of shame and humiliation, she said, ''I decided to put another face to the epidemic: an old, wrinkled face.''
Now Fowler and her organization, the National Association on HIV Over Fifty, educate the public about AIDS and older Americans.
AIDS, she said, is an especially lonely disease for older people. ''We have a double stigma. We have HIV and we are old.''
Older people tend to be diagnosed at a later stage of the disease, in part because of a lack of awareness that older people are vulnerable and in part because their symptoms mimic some of the symptoms of aging, said James Campbell of the Boston Department of Public Health's AIDS bureau.
As a result, they are often critically ill when they get their first diagnosis, lowering their chances of successful treatment.
Many older people hide their illness because they are afraid of how children and grandchildren will react, experts say. ''It's especially difficult for an older person to make that disclosure,'' said Fowler.
Fowler is doing well on a ''cocktail'' of drugs that has boosted her immune system and wiped out signs of the virus in her blood. Many others in her age group die within 90 days of diagnosis, said Campbell.
Older people are exposed to HIV mainly through sexual contact. ''Believe me,'' said Campbell, 53, who has AIDS, ''people over 50 are having sex.''
Gallagher said doctors are partly responsible for not testing people 50 and over for HIV even after they become ill.
''We are afraid to approach older people because we assume they don't want us to ask questions'' about their sex lives, said Gallagher. ''We need to get over that.''
Researchers, the experts say, need to include older people in studies of HIV, and look at how the new AIDS drugs interact with drugs typically taken by older people for such ailments as arthritis and high blood pressure.
More support groups are needed for older people with the disease, and educational materials must be developed targeting that age group, they said.
''This is a different population, a different culture if you will, and we need to acknowledge that and respond to it,'' said Campbell.


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