Aging and HIV issues

I recently fell down a rabbit hole looking at aging and HIV here in the US and thought it's interesting enough to share.There's a lot of concern for younger people and the spread of HIV, and rightfully so. Young people will carry the virus around for a long time, are precious because they're the future blah blah, you know the speel and already heard about what makes them an at risk group (or can easily imagine), I'm sure. But there is a growing population of those with HIV who are in their later years. And that reason is mostly twofold:a) Sex continues to be an important part of many people's lives as they age. While sexual activity does generally decline as people get older, it is still relatively common for people over, say, [57 to have sex](http://ift.tt/1IGkODS) (NYT). And that isn't limited to married couples. Older people in general are getting back into the groves with all the moves after loss, divorce, or a sexual hiatus, and this can be a problem. Doctors often assume an older patient is not sexually active and therefore do not proactively initiate sexual health discussions as often as they do with younger patients. And older patients are sometimes more sensitive to discussions about sex than some younger people, and would avoid talking to their doctors about it. This can result in the patient not being fully educated or sufficiently reminded of the risks and best practices. Importantly, it could also result in the patient not being tested for STIs like HIV, or getting delayed treatment.b) HIV treatment has greatly improved and many HIV+ persons are living longer than before. That, combined with the clock means more people with HIV are passing into retirement age. In fact, almost half of all people living with HIV are over 50 (source: CDC fact sheet below), and it is expected to go up (bolded).Okay, so those rates apply to all people past middle age, gay, straight, whatever. But it turns out men are horny dogs, and are more sexually active compared to women of a similar age (big surprise to gay guys, but source: fact sheet below). That means good news for daddy hunters like me, because we have a little more selection than hunters for their female counterparts. Yay!But that also means that because they are less likely to be adequately screened, there is some concern for their sexual health. And many of the risk factors for sexually active (gay) older men are the same for younger (gay) men, such as having multiple partners, unprotected (anal) sex, drug or alcohol use, and the possibility of other STI's. The risk of HIV spreading to this population is increased, and even moreso for aging gay men. And because of a few biases, doctors may mistake HIV symptoms of other illnesses from aging, delaying the diagnoses and subsequent treatment (see "Late HIV Diagnosis"). The CDC reports in the following fact sheet:Older Americans are more likely than younger Americans to be diagnosed with HIV infection late in the course of their disease, meaning a late start to treatment and possibly more damage to their immune system. This can lead to poorer prognoses and shorter survival after an HIV diagnosis. For instance, 98% of people aged 25-29 who were diagnosed with HIV infection during 2004-2009 survived more than 12 months after diagnosis, compared with an estimated 86% of people aged 50 to 59, 82% of people aged 60-64, and 73% of people aged 65 and older.Here is the pretty interesting fact sheet from the CDC about the aging population and HIV.And another from a solid LGBTQ aging-avocacy group, Sage.One side thing: it was only with combination drug therapy that started in 1996 that things started turning around for those infected. That is barely nine years ago. The long term effects of these drugs are being watched carefully to see how it affects the aging process. Some researchers believe that it cause a sort of premature ageing , although it is equally likely to be simply having HIV for a long time. HIV research is complicated, and it only gets moreso as we spend more time with it.So, guys, brothers and daddies, be smart out there.