liv poz mag.qxd - Positive Living BC

Feature Story
However, if we want to live out lives that are self-determined,
we must start to address a number of issues, ask
the right questions, and do the research required to
inf luence policy and services available in the not-sodistant
future. Some of the questions about access to care
that will directly affect us have been asked by many of the
national seniors’ organizations, but not in the context of
growing old with the complications of HIV.
Aging demographics—for Canadians and
for PWAs
The overall percentage of seniors age 65 and older in
Canada is projected to nearly double—from 13.2 percent
in 2005 to 24.5 percent by 2036. In addition, a growing
number of older adults are also being newly diagnosed
with HIV. The Public Health Agency of Canada reported
that by 2006, 14 percent of all reported positive HIV tests
were in individuals 50 or older, up from eight percent
between 1986 and 1998. The intersection of HIV and
aging is an emerging area of concern as individuals age
with HIV and experience more complex medical and
psychosocial problems.
Last month, the Parliamentary Budget Officer released
a major report giving the first look into Canada’s demographics
75 years into the future. With fewer people
working and paying taxes, coupled with a declining birth
rate, the report warned that the federal debt will continue
to increase if the government fails to reduce spending or
raise taxes.
By 2015, the majority of PWAs in Canada will be over
the age of 50, and this population has two distinct subgroups:
those who have been living with HIV/AIDS for
many years, and those newly diagnosed with HIV in their
later years. Each has its own set of unique issues.
MayqJune 2010 living5 21
New emerging issues around being older
with HIV
For those who have been living with HIV—and living with
the various generations of medications to treat the
disease, side effects from those medications, and the
effects of living with HIV itself—there appears to be a
trend of accelerated aging, even with successful viral
suppression. PWAs are increasingly experiencing medical
conditions more commonly associated with their parents
or grandparents, rather than their uninfected peers:
cardiovascular, renal, and liver diseases; cancer; osteoporosis;
arthritis; diabetes; hypertension; and various neurocognitiverelated
symptoms, ranging from memory loss to HIVassociated
dementia and cognitive motor disorders.
As for the second group, those who are over 50 and
are becoming newly infected with HIV—given that we
live in a society that hasn’t come to grips with ageism,
sex phobia, or death—it isn’t surprising that we haven’t
focused on developing prevention programming for
older adults. Although we may not like the idea that
our parents and even our grandparents are still sexually
active, the statistics show a different picture. Seniors
are still sexually active. Many retirees are dealing with
the loss of long-term partners and f ind themselves single
in a new world, with very little appropriate sexual
health information.
“The HIV community does
not care about aging and
the aging community does
not care about HIV.” –
authors Jim Truax and
Dr. Gordon Arbess
A 2009 bulletin by the World Health Organization
cautions: “HIV prevalence and incidence in the over-50-
year-olds seem surprisingly high and the risk factors are
totally unexplored.” Researchers point to a variety of
risks that increase the vulnerability of this group: the
advent of erectile dysfunction drugs in the late 1990s,
which has extended sex lives; the assumption on the part
of some older adults and healthcare providers that this
demographic isn’t at risk, which can lead to a lack of
screening or failed diagnoses; the discomfort of some
older adults and their healthcare providers to openly
discuss safer sex; and a lack of, or ineffective, targeted
prevention messaging.
PWAs not on the national aging radar
In an article entitled “The health of people living with
HIV” by Jim Truax and Dr. Gordon Arbess of St.
Michael’s Hospital in Toronto, the authors make a rather
alarming statement: “The HIV community does not care
about aging, and the aging community does not care
about HIV.” The article goes on to shed light on the lack
of prevention messaging to older adults in our community
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