The elderly population is increasing as baby boomers are beginning to appro
ach retirement. People 65 years of age or older already constitute approxim
ately one eighth of the U.S. population; this proportion is expected to dou
ble in the next 50 years. Older Americans have their own population-specifi
c health challenges, such as Alzheimer's disease, osteoporosis, adult-onset
diabetes, prostate cancer, menopause, and hypertension. Human immunodefici
ency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) ar
e seldom discussed within this community. Prevention, counseling, testing,
and education efforts are not bring directed their way. In addition, few pr
actitioners are experts both in HIV and health problems associated with agi
ng, resulting in misdiagnosis, especially in the early stages when AIDS sym
ptoms such as fatigue, weight loss, night sweats, and diminished appetite a
re dismissed as part of the aging process.
Very few HIV-related social support services have been aimed at the needs o
f the elderly, perhaps because older Americans are not suspected to be sexu
ally active or are assumed to be in a monogamous, heterosexual relationship
. Older Americans are not suspected of drug use. Yet many are sexually acti
ve, often demonstrating risky sexual behavior, such as dispensing with the
use of condoms; and the isolation that frequently accompanies old age can l
ead to alcoholism and injectable drug use.
This article examines methods suggested in the literature both in terms of
primary and secondary prevention of HIV/AIDS in older Americans. The cost o
f these efforts is enumerated, and organizations who gear their efforts in
reaching and educating older Americans regarding their risks are described.
(C) 2000 by the American College of Nurse-Midwives.