HIV/AIDS Among Middle and Older Adults in Puerto Rico

Abstract

Of all the AIDS cases reported through March 2004 in Puerto Rico, 34.8% were among the 40-59 age group, and 3.9% in persons 60 years and over. This represents 38.7% of all cases of AIDS in Puerto Rico. The percentage was higher among new AIDS cases diagnosed. Currently half of all new cases were 40 years and older. The most prevalent mode of exposure reported was related to sexual contact (heterosexual contact, male-male/bisexual sexual contact, male-male sexual contact and injection drug use). Injection drug use is identified as an important mode of exposure, particularly among males 40-59 years old. In the older generation, ignorance or the refusal to acknowledge their sexual interest and activity has resulted in a failure to adequately consider such health issues as sexually transmitted infections, including HIV in this population. Due to the increase of new AIDS cases and to the rapidly growing segment of the older adult population, middle and older adults are becoming an important group in need of HIV/AIDS prevention. With the intention of obtaining information on HIV risk factors among older adults a descriptive research was conducted. A non-probability sample of 157 men and 57 women 60 years and older from the San Juan Metropolitan Area was interviewed. The questionnaire included questions on HIV/AIDS knowledge, risk-perception, sexual practices, condom use and accessibility, HIV testing, alcohol and health and sociodemographic characteristics. The age range of the participants was 60-93 years old. The majority of respondents listed Social Security and food stamps as their primary source of income. Thirty-three percent of the male and 38.2% of the women perceived themselves as being at risk of HIV infection. Sexual relations during the last month were reported by 56.6% of the male and 13.2% of the women. They mention spouse, girl/boy friend as their usual partners; male also indicated casual partners and sex workers. The majority did not use condoms in their last sexual relation. Only 21% of males that reported sexual relations with sex worker always used condoms. Pharmacy was mentioned by the majority as the place where they obtain condoms. Forty five percent of female and 34% of the male had been tested for HIV. Gonorrhea was the most frequent sexually transmitted infection reported by males and trichomonas vaginalis by females. We are confronting a condition that affects the present population as well as future generations of older adults. Recommendations of health promotion and health education interventions that contribute to decrease the HIV/AIDS incidence and to eliminate stereotyping, discrimination and disparities in health care services for this population are identify.