By Siobhan Benet
Sunday, March 25, 2001
Menopausal and post-menopausal women remain sexually active and they may be much more susceptible to HIV/AIDS than younger women, but age prejudice may put blinders on health professionals who may mistake symptoms for those of natural aging.
(WOMENSENEWS)--In 1991, Jane Fowler received a letter from a health insurance company that literally changed her life. It stated that she had been rejected for coverage because of "significant blood abnormality." Fowler, a 55-year-old journalist, had been diagnosed with HIV.
Jane Fowler did not fit the HIV/AIDS stereotype. She had led a traditional life in Kansas City, Mo. She was a virgin on her wedding night, monogamous during 23 years of marriage. But in the early 1980s, Fowler was divorced and dating for the first time in almost 25 years.
The men she went out with shared similar backgrounds. She never suspected that she would be putting herself at risk by engaging in unprotected sex with an old friend whom she dated for three years.
Today, Fowler is fairly healthy and has become a safe-sex crusader for older women, also emphasizing the effects of ageism when it comes to older women's sexuality. She also has written of the effects of anti-viral drugs: diarrhea, nausea, hair loss, redistribution of body fat.
Women over 50, many of them dating again after long relationships, increasingly are contracting HIV/AIDS, but they usually are overlooked by health professionals who focus more on younger people and discount the sexuality of older women, experts say. Some physicians mistake the symptoms of HIV/AIDS for those of natural aging.
In addition, experts say, women over 50 may not practice safe sex because they no longer worry about pregnancy and they have less experience negotiating as a full partner with men about the need to use condoms.
The number of new AIDS cases in people 50 and over is rising twice as fast as in the 13-to-49 age group--and women, especially black women--have been hit especially hard, according to government figures.
According to the Centers for Disease Control and Prevention, only 11 percent of all U.S. HIV/AIDS cases reported to the centers have occurred in people 50 or over. But the number of new AIDS cases in this age group is rising twice as fast as the number in the 13-to-49 age group. Moreover, the National Institute on Aging reports that during a recent five-year period, the number of new AIDS cases in women 50 and over increased by 40 percent.
"This is the population that came of age during the sexual revolution," says Dr. Marcia Ory of the National Institute of Aging working group on HIV/AIDS and aging issues.
"Boomers have different types of behaviors, knowledge and experiences--this is a group that could be particularly affected by HIV/AIDS if they don't engage in safe practices," Ory says. "All the research shows that people in this age group believe that they are not at risk."
Before 1988, the Centers for Disease Control reported virtually no HIV infections traced to drug use in people over 50. Today drug use accounts for 17 percent of those infections. Seniors who share insulin syringes are also at risk.
For women over 50, however, unprotected sex poses the biggest threat.
Kathy Nokes, chair of the New York Task Force on HIV Over Fifty, attributes the rise in HIV/AIDS in women over 50 to "heterosexual women reentering the dating field after 20 to 30 years. Gender roles have changed and women are not quite sure how to negotiate safer sex."
Adds Monica Rodriguez, the director of information and education at the Sexuality Information and Education Council of the United States, "This isn't a population that grew up talking about sex or condoms or HIV/AIDS. But we can't let our discomfort around issues of sexuality get in the way of conversations about safe sex."
John Gargotta, supervisor of the Senior HIV Intervention Program, or SHIP, in Florida's Broward, Dade and Palm Beach counties, reports that those over 50 constitute 15 percent of newly-diagnosed HIV/AIDS cases. "Down here, there are several women to every man," says Gargotta.
"One thing you won't spot in the gauzy, romantic ads for Viagra is a warning about AIDS," wrote Leslie Laurence and Lani Luciano in their article, "The Aging Face of AIDS," published on World AIDS Day 2000 by the Henry J. Kaiser Family Foundation.
Pfizer, the manufacturer of Viagra, now includes safe sex messages in its advertising and the Veterans Administration has instituted a two-part prescription that includes Viagra and condoms.
When menopausal women forgo the use of condoms, they put themselves at risk. Some menopausal and post-menopausal woman may have vaginal dryness and thinning of the vaginal walls that make them vulnerable to small tears and abrasions that can increase the risk of HIV infection during unprotected sex.
"The lack of prevention for older people lies in our attitudes about aging. Ageism prevents us from seeing old people as sexual, individual human beings," says Regina Shavers of the New York City Department of Health.
A study of doctors in Texas found that most doctors rarely or never asked their 50-and-over patients questions about HIV/AIDS or discussed how to reduce risk. Experts say this lack of questioning is disturbing because many of the symptoms of HIV/AIDS mirror those of menopause--hot flashes, night sweats and depression.
Advocates are concerned that doctors sometimes confuse HIV/AIDS symptoms with those of natural aging. By the time the patient is properly diagnosed with HIV/AIDS, the disease may be full-blown.
Jane Fowler, who is a co-founder and the current co-chairperson of the National Association on HIV Over Fifty, is at the forefront of the struggle to bring AIDS in women over 50 to mainstream attention.
She spends much of her time traveling the country, lecturing to health care providers and seniors about HIV/AIDS in the over-50 population.
Fowler worries that she may not be reaching the audience that most needs to hear her message--other women.
Too few HIV prevention presentations are in settings where I talk directly to older women or to those who provide medical or social services to them," Fowler said in an interview. "The prevailing, naive attitude that senior women are not at risk for the viral infection and don't need prevention information, must be reversed--in everyone's mind."
Siobhan Benet is a free-lance writer based in New York.
A special daily feature of Women's Enews during Women's History Month
(WOMENSENEWS)--1991. Anita Faye Hill, a law professor in Oklahoma, tells investigators with the Senate Judiciary Committee that Clarence Thomas, a nominee for the Supreme Court, sexually harassed her when they worked together at the U.S. Education Department and the Equal Opportunity Employment Commission.
The investigators paid little attention to her allegations until Nina Totenberg reported them on National Public Radio. Women across America demanded that the Senate committee hear Hill. Reluctantly, the Judiciary Committee, which had no women members, agreed. The subsequent hearings were incendiary on several levels, a defining moment in the struggle over sexual harassment and credibility.
Thomas was confirmed. He is one of the court's consistently most conservative voices. --Glenda Crank Holste.