Menopause and Risk for HIV

If you are in menopause, chances are you are much more worried about hot flashes and brain fog than HIV. In fact, HIV may not ever cross your mind. But looking at the statistics, perhaps it should, especially if you are dating and at risk for the disease.

Here's why:

  • Both men and women over 50 have many similar HIV risk factors as younger people, but may not be as aware of these risks
  • People 55 and older represent one-quarter (288,700) or the 1.2 million Americans in 2012 currently with HIV
  • Older Americans who are diagnosed with HIV typically are diagnosed later in the course of their disease.

HIV and AIDS Diagnoses and Deaths

  • In 2013, the largest number of cases of HIV in people over the age of 50 occurred among people aged 50 to 54. 
  • In 2013, according to the CDC, persons aged 50 to 54, the estimated rate of infection was 59/100,00 among black Americans, 23/100,000 among Hispanics and 9/100,000 among whites. 
  • 37% of the 6,955 deaths related to AIDS in 2013 occurred in people aged 55 and older.

Prevention Challenges

I know that when I consult with women in my practice who are newly widowed or divorced and they are now interested in dating again, they are typically a long time away from their dating days. The idea of safe sex and worrying about HIV is something they haven't thought about. Often my discussion with them is about safe sex and dating safety in general. Because HIV isn't something many women in menopause are thinking about, if they do catch HIV, they are more likely than younger women to have the disease progress further before getting diagnosed, which means starting treatment late and possibly suffering more immune-system damage.

The unfortunate outcome is they live a shorter life and aren't as likely to get treated early enough to have effective treatment.

That is really too bad because people aged 20 to 24 who were diagnosed with HIV infection during 2004-2009 had a 99% survival for more than 12 months after diagnosis, compared with roughly 89% of people aged 50 to 54,

People over 50 are typically sexually active, including those living with HIV, and may have many of the same HIV risk factors as younger people such as not always knowing how HIV gets transmitted. Another big issue is that women over 50 aren't worried about getting pregnant so they are less likely to use a condom. Also, those with lower estrogen levels often have vaginal dryness and thinner walls of their vaginas and that can lead to tears and cuts with penetration, which makes it easier for the HIV virus to cause an infection. We also know that many women don't discuss their sexual activity in their doctor's visits and many doctors still don't ask. So it's a perfect storm for HIV and other sexually transmitted diseases not to be discovered.

It can be a brave new world when dating starts up after a long period of being with just one person. For that reason, it's important to talk with your healthcare provider about any new sexual activity and ask for information about safe sex practices.

If you are interested in information about HIV, you can find it at Act Against AIDS, a national communications initiative that focuses on raising awareness, and reducing the risk of HIV infection. There is also another initiative called Prevention IS Care, which provides continuing education and materials to doctors and healthcare providers to help people living with HIV infection.

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