As I have pointed out in earlier posts and whether we want to go there or not, your baby boomer parents are likely to be sexually active. This can pose a problem when we think of HIV prevention because - well really - who's gonna get pregnant over the age of 50? As such, older adults are rarely thinking of condom use when they become involved in an intimate relationship. This becomes even more of an issue for women as they age because the lining of the vagina becomes much more fragile from dryness and thinning increasing the likelihood of tearing. In addition to this, women face the reality (similar to that of younger women) of being in the sometimes uncomfortable position of having to negotiate condom use.
There is also the thought that older generations may be less informed about sexually transmitted infections such as HIV compared to that of younger folks partly because HIV was not a big part of their world when they were sexually active in their younger years and partly because they don't see themselves as being at risk. This can lead to the misconception that condom use and regular testing for HIV is not something they need to worry about. I, personally, would add here that the baby boomer generation has also been identified as a highly informed group when it comes to their health so it is important to take all of this into consideration. Regardless, openly talking about sexual activity, regular testing for HIV, and promotion of condom use should be come a regular part of caring for older adults in primary care so we can break down the walls of stigma built up around sex in this population!
Which is a superb segue into issues of stigma as an obstacle to prevention. While there are scattered articles about HIV related stigma we are a long way from knowing exactly how it affects older adults who are at risk for HIV. Some believe there is little difference between older and younger populations and then there are those believe the exact opposite. The CDC, for example, states that older adults may indeed be more highly affected by stigma robbing them of key emotional and spiritual support systems that might lead to early detection of HIV as well as prevention support. On top of HIV related stigma it is prudent to be aware of other forms of stigma including age, race, as well as sexual and gender identity. All of these can lead to decreased likelihood of seeking care and support from both family and the health care system.
This gives you a general idea of what we need to consider when we think of HIV prevention in older adults! I was very pleased to see amongst my browsing (some links will be posted below) to see that the general trend in prevention programs are now using a multifaceted approach in that, rather than simply telling a person to use condoms and get tested, the idea now is to use variations of prevention such as safer sexual practices, behavioral interventions, and medicinal considerations.
Anyway, here are some interesting sites to check out and browse!
http://www.thebody.com/content/64420/hiv-prevention-and-older-adults.html
http://www.med.unc.edu/aging/elderhiv/act.htm
http://www.med.unc.edu/aging/elderhiv/act.htm
http://aids.about.com/cs/aidsfactsheets/a/seniors.htm
http://caps.ucsf.edu/uploads/pubs/FS/over50.php
ENJOY!! :D
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