Menstuff® has compiled information and books on the issue of
AIDS and elder Americans. Plus the HIV Information
Center 
Elders and AIDS
Resouces: AIDS & Aging
Assistant Secretary on Aging Jeanette C. Takamura in the kick off for the International Year of the Older Person indicated that “ in less than 13 years 77 million baby boomers would begin to join the ranks of Older Americans.” As the effectiveness of treatment regimens increases, baby boomers with HIV infections are living longer and will be entering older age cohorts.
When I began to think about how to write this article, I was clear that I didn’t want it to be an article filled with just statistical data. I wanted it to have a face. I felt that one of the most important ways to get my point across was to add a human face to the information to be provided. Edward Shaw, or Ed as most people call him, was just the person I needed in order to make this relevant to the many people who might read it.
Ed Shaw is a PWA ( Person With AIDS) African American male who is 58 years old. He is currently a consumer advocate and a member of the HIV Health and Human Services Planning Council of New York. He was appointed by Mayor Giuliani last year. He is involved with the Community Advisory Boards of Harlem Hospital and the Harlem Directors Group. He also serves as a Community Advisor to the New York State Department of Health and is a member of the New York Association on HIV Over 50.
In the summer of 1988 Ed Shaw was informed of his HIV positive status. According to Ed:
“ Life as I knew it ended with a death sentence.” In Ed’s mind death was only a matter of weeks away or so he thought. This prognosis did not prompt Ed into cleaning up his act, rather his denial and anger about his situation thrust him into more aggressive continued use of substances, even sharing needles from time to time. He drank heavily and continued to be involved in risky sexual behavior. Denial became a way of life for Ed for nearly five years. During 1992 Ed’s hospitalizations began and he experienced a series of episodic bouts with various opportunistic infections due to his weakened immune system. In February of 1995 he spent a month at Cabrini Hospital in New York recovering from a diagnosis of respiratory failure. Upon his discharge he was told by his case-manager that his T-cell count was well below 200. On his return to his primary care hospital he was told by his case-manager that he had AIDS. According to Ed this statement alone was the beginning of his recovery from the use of alcohol and drugs.
“The CD4 cell ("T-cell") count is a test which measures the number of CD4 cells in a blood sample. Normal CD4 counts in adults range from 500 to1500 cells per cubic millimeter of volume. In general, the CD4 count goes down as HIV disease progresses. Any single CD4 count value may be different from the last one even though your health status has not changed. You should not place too much importance on any one result; what is more important than any single value is the trend of CD4 counts over time.”
“The CD4 count does not always reflect how someone with HIV disease feels and functions. For example, some people with higher CD4 counts are ill and have frequent complications, and some people with low CD4 counts have few medical complications and function well (They are known as long-term non- progressives). HIV-infected persons with CD4 counts below 200 are considered to have AIDS regardless of whether they are sick or well, according to criteria established by the Centers for Disease Control and Prevention.” (Source: National AIDS Treatment Information Project, Beth Israel Deaconess Medical Center).
As a volunteer at long term care facilities Ed has seen a number of elderly who have progressed to full blown AIDS due to the lack of early interventions and proper diagnosis, making medical treatment much more difficult, both because of the late diagnosis and other factors related to age.
An article by the Center For AIDS and Prevention Studies UCSF. AIDS Research Center reported that “ Cases among older people may be under-reported, as HIV symptoms and infections may coincide with other diseases associated with aging and thus be overlooked. AIDS related dementia is often mis-diagnosed as Alzheimers and early HIV symptoms such as fatigue and weight loss maybe dismissed as a normal part of Aging”
The fact the older people are involved in risky sexual behaviors and not necessarily monogamous relationships places them in a more vulnerable position. According to an article sponsored by the University of Alabama School of Medicine HIV Disease After Age 50 “ A shift in transmission risk among persons aged 50 years and older has been observed in recent years. Although homosexual and bisexual contact and injection drug use remain the primary means by which HIV is transmitted across all age groups, heterosexual transmission of HIV is steadily increasing in persons more than 50 years of age.” In a study of hospitalized HIV infected patients aged 60 years and older found that the majority acquired their infection through sexual intercourse (38%) or injection drug use (16%) with transfusion accounting for only 9% of cases. In addition the CDC has reported that heterosexual contact was the route of transmission in 14.5% of AIDS cases among persons aged 50 years and older.
Ed believes that Prevention Education should be at the forefront in dealing with HIV and the person over 50. Those involved in the education process of the older person should include not only governmental institutions but faith based institutions as well as other community groups and organizations. Unfortunately few prevention programs that target adults over 50 exist.
A prevention model should include but not be limited to the following:
On January 14, 1998, the Department of Health and Human Services Region II sponsored a Community Meeting on HIV and AIDS at SUNY Downstate Medical Center. One of the topics covered was HIV/AIDS and People over 50. Following are the recommendations which came out of this workgroup.
|
Sex |
|
|
|
|
|
Age |
|
|
|
|
|
White |
228,697 |
28,446 |
19,353 |
2,576 |
|
African Am |
146,095 |
17,178 |
49,608 |
4,099 |
|
Latino |
81,389 |
8,315 |
17,983 |
1,565 |
|
Asian/PI |
3,429 |
444 |
419 |
78 |
|
Native Am |
1,327 |
76 |
252 |
22 |
|
Total |
460,937 |
54,459 |
87,615 |
8,340 |
Consumers View for the future:
In addition to the recommendations that came out of our Regional Community Meeting on HIV, Ed believes that “ Education is the key which will lead to a greater amount of empowerment among the elderly”. One of the ways in which Ed accomplished the task was to involve himself in advocacy and activism, speaking up, speaking out and speaking often for those unable or unwilling to speak for themselves. This proactive position must continue to be a part of an on-going process, in order to overcome the many obstacles and barriers that are prevalent in our society today.
When I last saw Ed he was talking to a group of first year medical resident students at a community hospital, about his road to recovery and his experiences as a person living with AIDS. He was planting the seed of awareness about the many issues affecting the person with HIV.
Ed believes that since we still have not found a cure for AIDS and while it continues to be a clinically manageable disease we must challenge ourselves to do everything we can to educate older persons. Our assistance will count we can make a difference. Edward Shaw appeals to all citizens for help. To Ed, I say bravo, to the rest of us I say we have our work cut out for us so let’s get involved. Anyone wishing to contact Ed to assist him in the fight against the spread of this virus can write to: Edward Shaw, 305 West 97th Street, #3C, New York, NY 10025 (212) 864-9118.
Resources:
National Association On HIV Over 50 (NAHOF), Midwest Aids Training & Education Center, University of Illinois, 808 S. Wood Street, M/C779 Chicago, IL 60612 (312) 996-1426
National Institutes On Aging - www.nih.gov/nia
American Association Of Retired Person (AARP), Social Outreach And Support (SOS), 601 E. Street, NW, Washington, DC 20049, (202) 434-2260
NY HIV Over 50 Task Force - Brookdale Center On Aging,
Hunter College, 425 E.25th Street, New York , NY 10010, (212)
481-7594, Contact: Kathy Nokes, kathynokes@aol.com
Article Written By: Carmen Sanchez, DHHS Administration On Aging, Region II & III, in Consultation With : Edward Shaw, Consumer Advocate
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