Older adults acquire HIV, but prevention focuses on young people

Prevention and treatment campaigns do not adequately target the special needs of the age group over 50. Indeed, between 2000 and 2016, the number of adults aged 50 and more alive with HIV in sub -Saharan Africa has doubled. At present, their HIV prevalence exceeds that of young adults.

By 2040, a quarter of people living with HIV in Africa will be aged 50 and over; Custom awareness and treatment campaigns are pressing.

Dr Houscer Olubayo, researcher at Sydney Brenner Institute for Molecular Bioscience (SBIMB) at Wits University and the first author of a study published in Healthy longevity Lancet The fact that HIV has studied the elderly in Kenya and South Africa noted that the perceptions of who acquires HIV are limited. “We often consider HIV as a disease of young people. This does not help that intervention campaigns are mainly intended for young people.”

In addition, the elderly are less likely to believe that they can get HIV. This false idea is omnipresent and has consequences to achieve global objectives to achieve the objectives 95-95-95 of Uniads by 2030 (95% of people living with HIV know their status, 95% of people who know their status are under treatment and 95% have a deleted viral load).

“While the prevalence of HIV in individuals over 50 is similar or even exceeds that of young adults, HIV surveys focus on the youngest, leaving considerable gaps to understand the prevalence of HIV, the incidence and the results of treatment in older populations,” said Associate Professor F. Xavier Gómez-Olivé, the MRC / Wits-Wits Research Unit.

Stigmatization remains an obstacle to treatment

The absorption of HIV tests in the elderly is poor, which delays diagnosis and limits access to care. It is indeed one of the signifiers of the omnipresence of the stigma surrounding the disease.

“We know that there is a significant social stigma linked to HIV infection. This is why understanding of HIV-related stigma in the elderly remains crucial as a means of informing interventions aimed at supporting the mental health of the elderly and general well-being,” said Olubayo.

Interventions could focus on repeated tests, the use of prophylaxis prior to exposure (PREP) and campaigns to increase awareness and reduce infections in the elderly.

“HIV can also be managed alongside other chronic conditions, because HIV is managed as a long-term disease,” explains Gómez-Olivé.

Non -transmitted diseases, such as hypertension, diabetes and obesity, have increased considerably in sub -Saharan Africa, especially in the elderly. HIV treatment and intervention can be included in the long -term health care ecosystem.

In addition to stigma, a complex interaction of factors shapes the risk of HIV

The study shows that age, education, sex and where people live all of their risk of HIV. Even if more people now have access to HIV treatment, the elderly – especially in rural areas – are still faced with significant challenges to prevent HIV, such as low levels of education and gender inequalities.

Widowed women had the highest HIV rate (30.8%). This may be due to the loss of a partner against HIV, stigma and a greater risk of dangerous behavior such as transactional sex and limited power to negotiate the use of condoms. With people without formal education and those who have low incomes also had higher rates of HIV infection.

The advantage of longitudinal data to make decisions

An important added value of this study is the supply of longitudinal knowledge on the HIV epidemic in the elderly in sub -Saharan Africa. “Our study is beneficial insofar as older populations are under-represented, and we do not know much over time. What changes happen? We must answer this kind of questions. With longitudinal data, we can examine the effectiveness of antiretroviral coverage in the elderly,” explains Gómez-Olivé.

The study used data collected in Urban Kenya and in urban and rural sites across South Africa for two data collection waves: 2013-2016 and 2019-2022.

Throughout a decade of research, the team has acquired a more in -depth understanding of this aging HIV epidemic. Many important information on HIV in older populations has been carried out and research gaps is covered.