Rates of HIV infection among people over 50 appear to be on the rise - perhaps in part to the increased use of erectile-dysfunction drugs, global experts are warning.
In an article published in the World Health Organization's Bulletin on Tuesday, WHO experts warn that HIV is still rarely considered a risk for older individuals, even though seniors are considered more likely than younger people to risk unprotected sex.
"HIV prevalence and incidence in the over-50-year-olds seem surprisingly high and the risk factors are totally unexplored," the authors from the WHO and Minnesota's St. Olaf College write.
Patients over the age of 50 make up roughly eight per cent of new HIV diagnoses in Europe and 11 per cent in the United States, the report finds. And in Brazil, HIV infection among those aged over 50 years doubled between 1996 and 2006, jumping from 7.5 to 15.7 cases per 100 000 inhabitants.
The numbers in Canada are unclear, since Public Health Agency of Canada did not separate data about HIV infection rates for people older than 49 in its 2007 HIV/AIDS Surveillance Report. But in 2004, it said about 10 per cent of positive HIV test reports in Canada each year since the beginning of the AIDS epidemic have been among those aged 50 years or older.
PHAC says very little research has been conducted on risky sexual behaviour in seniors.
"HIV/AIDS is generally believed to be a young person's disease and, therefore, little focus has been given to the issue of HIV/AIDS among older Canadians," the agency has said.
The WHO report notes that doctors are not screening for HIV among older adults, because they are mistakenly assumed not to be at risk. The Ninth United Nation World Assembly on Aging in 2002 noted that health professionals tend not to question their elderly patients about their sexual behaviour, nor give them the same information on prevention that they give to young people.
This means that many cases of HIV among those over 50 go undiagnosed -- which means those patients don't receive life-saving antiviral therapy.
"These individuals have a shorter time from diagnosis to the onset of AIDS, reflecting both age-related faster progression to AIDS and doctors' failure to consider HIV as a diagnosis," the report said.
As baby boomers age and divorce or are widowed, many are remaining sexually active, often with multiple partners. The WHO report suggests that part of the reason is the increasing use of erectile dysfunction drugs.
"Because of erectile dysfunction drugs, men, who would normally decrease or cease sexual activity as they age, have extended their sex lives," said Dr. George Schmid, a medical officer at the World Health Organization.
Schmid notes that anti-impotence drugs may lead to sexual activity in unsafe conditions, adding: "(Erectile dysfunction) drugs can also be used for partying."
What's more, older people may not be as aware as their younger counterparts of the risks involved in having unprotected sex.
"Older people became sexually active in a world where there was no AIDS," noted Ivo Brito of Brazil's Ministry of Health. "They were not accustomed to using condoms."
The danger may be compounded by older men seeking out younger, sexually active women, which increases their chances of exposure to HIV.
The authors concluded: "Understanding the epidemiology of HIV infection in older individuals can lead to interventions to make these years safer and more enjoyable."
