Elderly forgotten in the HIV fight

By Maria Kwesiga

Tackling HIV has been a priority in Uganda for over 25 years. There are a number of programmes providing prevention, treatment and care, but most exclude the elderly.  

HIV was previously thought to affect the elderly mainly. They were thought to be caregivers of loved ones living with HIV or the orphans they leave behind.

However, with the advent of antiretroviral treatment (ART), life expectancies for people living with HIV is steadily increasing.  The HIV-positive elderly population, defined as those older than 50 years, makes up 14% of the total HIV burden among individuals older than 15 years worldwide.  

In Uganda, approximately 7% of adults are HIV positive, higher than the 5.4% of the population aged 15-49.  Though they have higher prevalence, there is not much information on how the epidemic has and is affecting this group besides being caregivers.  

The burden of disease is almost always ignored, representing a significant missed opportunity in the response to the epidemic. 

One factor is the limited reporting, with most of the HIV/AIDS statistics in Uganda limited to individuals aged 49 years and below, focusing on those that are believed to be sexually active and of reproductive age, however, those over 50 are still very much at risk. 

One consistent finding is the failure to consider HIV as a cause of illness in older individuals.  These individuals tend to have a shorter time from diagnosis of HIV to the progression to AIDS, due to age and doctors’ failure to consider HIV as a diagnosis with screening less common for older adults.  

Studies have also shown men in sub-Saharan countries over 50 were more likely to have two or more sexual partners in the last 12 months than their younger counterparts.  

They also failed to use condoms as often. In a survey conducted by the Uganda Reach the Aged Association (URAA) in Kasese, 64% of older persons reported being sexually active, but 91% revealed that they had never used condoms in their lives.

These findings show that older people are neglected in the AIDS response.  There is therefore, need for further intervention and prevention campaigns for this group.  

The writer is a MakSPH-CDC HIV/AIDS Fellow at Mildmay