HIV and PrEP considerations for older adults - Primary Health

HIV and PrEP considerations for older adults

  • September 18, 2023

  • Adi Chandrasekhar, MD, MPH, FACP

  • 3 minutes

Many sexually active older adults lack access to sexual healthcare. Primary.Health powers community-based testing, prevention and treatment of HIV and other infections.

United States Census data from 2020 showed the fastest rise in the population of older Americans in over a century. An estimated 55.8 million people in the country were over the age of 65 and accounted for about one in six people. With advances in medical care allowing for improved longevity, one would anticipate this number to grow in years to come. As our healthcare system evolves to better serve this older population, we must recognize them first and foremost as people with real lives and real needs. 

Far too often, care for older adults has been reduced to tackling frailty, chronic illness, and end-of-life care. However, while many aging adults face these very real issues, we cannot forget that many of them lead active lifestyles — including active sexual lives. Contrary to popular belief, there is not a decline in sexual desire or function for most older adults. For instance, a British survey indicated that 85 percent of men were sexually active in their 60s, 60 percent in their 70s and 32 percent into their 80s. As with younger patients, they remain at risk for sexually transmitted infections (STIs), including Human Immunodeficiency Virus (HIV).

The Centers for Disease Control & Prevention (CDC) reports age figures for HIV by including people over 55 into a single cohort. Just under 4,000 people in that cohort were diagnosed with HIV in the year 2019. While about two-thirds of those were men, women aged over 55 accounted for about one in six infections in women overall. This age cohort is also among those that did not see a decline in HIV infection rates compared to many others. 

PrEP benefits for older adults

The advent of pre-exposure prophylaxis against HIV (PrEP) around a decade ago revolutionized our public health approach to HIV prevention. Unfortunately, that revolution has often ignored the benefits for older Americans. Only 21 percent of adults aged over 55 that could benefit from PrEP were prescribed the medication. This resulted from some early hesitancy on the part of providers and patients related to potential kidney-related side effects from PrEP medications. However, that’s been less of a concern with careful monitoring and the introduction of newer options that are safer for the kidneys. 

Additionally, poverty, HIV stigma, homophobia, and transphobia can all account for some challenges many older adults face in accessing HIV prevention and treatment services. Overcoming these challenges will be key to ending the epidemic among adults 65 and over. So on this National HIV/AIDS and Aging Awareness Day, join us in taking steps to make testing, PrEP, and HIV treatment more accessible for our aging adults. They deserve a chance to lead healthy sexual lives in the golden years of their life!

Primary.Health empowers communities to provide easy, accessible testing and treatment for HIV and other STIs for all ages to stop the spread of infectious disease.

Disclaimer: This blog content and linked materials are not intended as individual medical advice, diagnosis or treatment, and should not be considered as such. Any readers with medical concerns should contact a licensed healthcare provider. This blog is provided for informational purposes only.