People of different age groups are affected by HIV in diverse ways. The elderly, aged 50 years and above, have not been spared.

The major burden that has been placed on the elderly is that of caring for the sick children and grandchildren as well as for other relatives. Old people are also at risk of HIV infection, although this is not often appreciated.

While many old people are directly and indirectly affected by HIV, they are not directly targeted by most prevention and awareness programmes. The impact of the pandemic on this age group also remains under-reported. As a result, most elderly  people lack the knowledge of how to protect themselves against infection as well as how to treat the disease.

HOW MANY OLD PEOPLE ARE LIVING WITH HIV AND AIDS?

The number of people living with HIV above the age of 50 has been increasing in recent years. This increase is partly due to highly active antiretroviral therapy (HAART), which has made it possible for many people living with HIV (PLHIV) to live longer and partly due to newly diagnosed infections in persons over the age of 50.

According to PlusNews (2007), in its examination of HIV programs for people over the age of 50 in Africa, one in 14 HIV-positive people worldwide is above 50 years of age. PlusNews also noted that few programs provide HIV and prevention services for older people, even though they are considered to be at risk of contracting HIV. HelpAge International has noted that most data on HIV prevalence is collected only for adults aged 15 to 49.

HOW MANY OLD AGED HAVE THE RESPONSIBILITY OF CARING FOR THE SICK?

In sub-Saharan Africa, about 13 million children have lost one or both parents to AIDS. Many of these orphans now live in grandparent-headed households.

A study conducted by the World Health Organisation (2002) in Zimbabwe found out that over 70 percent of carers of people with HIV-related illnesses are over 60 years.

WHAT ARE SOME OF THE PROBLEMS THAT THE OLD AGED FACE?
Old people may not have a clear understanding of the nature, cause and how HIV is transmitted as they seldom have access to information. Awareness campaigns typically target the young and not the old.

Caring responsibilities also have financial implications on the elderly. These elderly grandparents have to meet the costs of daily living, providing food and clothes, as well as funding their grandchildren's education. They often get distressed of they fail to provide for the people they care for.

The lack of free treatment and affordable, accessible medicines adds to caregivers’ financial burdens.

Older people mainly face problems of exhaustion, grief and stress. They also lack the knowledge and resources to deal with children living with HIV, social stigma and discrimination and exclusion from information and support services. The strain of caring for people living with AIDS in the final stages of the illness can also be harrowing and tiring, and takes its toll on older people’s own health.

WHY ARE OLDER PEOPLE GETTING INFECTED?
There are several reasons why older people get infected. Some of the reasons include the fact that:

• Older people may lack awareness of the risk factors for getting HIV. Very little HIV prevention education is targeted at older people
• Many older people believe that HIV only affects younger people
• Most older people do not get training in safer sexual activities.
• Physicians may not diagnose HIV infection in older people. Some early symptoms of HIV may appear to be signs of normal aging.
• The stigma of having HIV and AIDS may be worse for older people. This can result in hiding their infection from family and friends.

WHAT ARE OF THE CHALLENGES THAT OLD PEOPLE FACE?

Persons over the age of 50 may have many of the same risk factors for HIV infection that younger persons have.

• Many older persons are sexually active but may not be practicing safer sex to reduce their risk for HIV infection.
• Some older persons inject. HIV transmission through injection drug use accounts for more than 16 percent of AIDS cases among persons aged 50 and older.
• Some older persons, compared with those who are younger, may be less knowledgeable about HIV and AIDS and therefore less likely to protect themselves. Many do not perceive themselves at risk of HIV, do not use condoms, and do not get tested for HIV.
• Older persons of minority races or ethnicities may face discrimination and stigma that can lead to later testing, diagnosis, and reluctance to seek services.
• Health care professionals may underestimate their older patients' risk for HIV and AIDS and thus may miss opportunities to deliver prevention messages, offer HIV testing, or make an early diagnosis that could help their patients get early care.
• The stigma of HIV and AIDS may be more severe among older persons, leading them to hide their diagnosis from family and friends. Failure to disclose HIV infection may limit or preclude potential emotional and practical support.

WHAT CAN THE MEDIA DO?

• The media can raise awareness of HIV and AIDS in older people and reinforce the need for educational programs, while promoting respect and validation for the elderly as a group.
• Lobby for old people to be supported in their role as carers for PLHIV and for orphans and vulnerable children. Old people need economic support to meet household costs including food and healthcare; to provide education and clothing for grandchildren; for treatment and travel to clinics to care for sick children; and to compensate for loss of earnings or family support.
• The media can provide information on HIV prevention, treatment, care and support. Old people need education on how HIV is transmitted and prevented, education on recognising symptoms of HIV in a family member; education on how to care for a family member with HIV including treating common infections; and access to HIV and AIDS support groups and services.

• The media can help older people to deal with issues of stigma and discrimination that results from being HIV positive at an old age and having a child or grandchild with HIV and AIDS.
• The media can also lobby for the availability and access to treatment and support for older people with HIV and AIDS.
• Research on media coverage has shown that old people are not visible in the media and therefore, the media can provide a platform for the old people to raise their concerns and to speak out on HIV and AIDS issues.

SOURCES
1. http://www.aidsinfonet.org/fact_sheets/view/616        accessed on 16 September 2009
2. http://www.helpage.org/Worldwide/Africa/Keyprojects/SupportingoldercarersaffectedbyHIVAIDS   accessed on 17 September 2009
3. http://www.odihpn.org/report.asp?ID=2740  accessed on 17 September 2009
4. http://www.thebody.com/content/news/art43863.html            accessed on 16 September 2009
5. http://www.thebody.com/content/whatis/art46524.html          accessed on 16 September 2009
6. http://www.who.int/mediacentre/news/releases/pr95/en/         accessed on 17 September 2009