Issues of HIV in the elderly

HIV/AIDS pandemic is well known to cause morbidity and mortality in those affected worldwide. HIV/AIDS like any other illness knows no age, race or geographical boundary. Therefore it can affect people of any age. Young people are known to suffer and die premature deaths due to HIV related illness. But less attention is given to elderly people in context of HIV or those living with HIV. Some elderly people may be suffering from HIV infection from a long time and it may not progress to AIDS and its related diseases. In some, the disease may progress and the individual may develop features of immune deficiency and related illnesses. Some individuals may acquire HIV infection in the late phase of their lives. Routes of infection in older people are the same as for younger individuals. That is the infection can be acquired through unsafe sexual practices, blood transfusions, or injections by unsterile syringes or needles. But issues of HIV infection become different in elderly people as compared to younger persons. First is the diagnosis, which needs suspicion. Many AIDS related diseases like cerebral toxoplasmosis or lymphomas, when present in elder persons, mimic other problems related to advancing age like stroke, dementia, e.t.c. nobody thinks of HIV/AIDS when an old man or woman develops unconsciousness, convulsions or paralysis of limbs. The problem comes when this person is treated for other conditions and one fails to get desired response or new unexpected complications develop. Many non specific features of chronic HIV infection like loss of appetite, loss of weight, extreme weakness, if occurring in some individuals, are presumed to be due as part of aging process. Not much attention is given to sexual behavior of an elderly gentleman or lady. In fact, one would feel embarrassed about discussing sex with some older person. But fact is, irrespective of their ages, they are human beings first. Any adult can be sexually active as long as possible, if they desire and have no factors to induce impotence. The frequency of intercourse may be less. But it needs one single intercourse to acquire or transmit HIV infection. An elderly person may be as or more ignorant than a younger one regarding HIV/AIDS. He may not have been counseled against it even, considering his age. Another problem faced by the elderly may be taking care of a younger family member may be a son or daughter suffering from AIDS. Unless properly informed and counseled about, they may not understand the illness of the family member properly. Inadvertently during nursing of the child they may expose themselves to risk of AIDS. This becomes more important if the younger member is terminally sick with HIV/AIDS. An old couple may be burdened with the task of taking care of a grandchild, who has been orphaned by HIV/AIDS. If not informed, they may not be aware of the importance of getting the grand child tested for HIV. If the small child in question is indeed suffering from HIV infection it is important for the grand father or mother as guardians to understand the need for regular monitoring of CD4 count by tests in the child, avoiding opportunistic infections, good nutritious food, adherence to ARV therapy and also to watch for unpleasant side effects of drugs. There may be untimely death of a young individual due to HIV related causes among relatives or neighbours, which may be traumatic psychologically for the elderly living in that area. Therefore in context of prevention of HIV/AIDS and keeping the burden of related sickness low in any community, it is important to counsel the elders and inform them about HIV/AIDS. If sexually active, they have to take precautions. While receiving injections or blood transfusions for any sickness, they should ensure that the syringes, needles and blood used is not infected. As care takers of somebody suffering from HIV they should be having information on how to maintain good hygiene to prevent occurrence of infections in the patient as well as save themselves from acquiring HIV. Elders when informed about HIV/AIDS can counsel the younger members of the family better and monitor them for any high risk behaviour. This shall definitely help in better prevention of the illness. –rachna212002@yahoo.co.uk