At AIDS summit, a focus on females, older patients

Posted: July 27, 2012

WASHINGTON - The AIDS epidemic increasingly is a female one, and women are making the case at the world's largest AIDS meeting that curbing it will require focusing on poverty and violence, not just pregnancy and pills.

Already, women make up half of the world's HIV infections, and adolescent girls are at particular risk in the hardest-hit parts of the world, UNICEF deputy executive director Geeta Rao Gupta told the International AIDS Conference.

About 4.8 million people 15 to 24 are living with HIV, and two-thirds are female. Chief risks in developing countries are sexual violence and conditions of poverty that frequently lead to girls' leaving school and marrying in their teens - often to much older men - for economic security, Rao Gupta said.

She echoed what has become a recurring theme of the meeting since Secretary of State Hillary Rodham Clinton declared Monday that gender equity would be crucial to protecting women. "Women need and deserve a voice in the decisions that affect their lives," Clinton said.

In South Sudan, Evelyn Letio Unzi Boki said, "men don't accept to go for testing," and their often younger and uneducated wives, dependent on them for economic survival, have no recourse.

Rao Gupta called for innovative solutions to help women and girls protect themselves. She pointed to an experiment in Kenya that pays poor families a few dollars a month to help support AIDS orphans and other vulnerable children.

Patients growing older. By the end of the decade, the U.S. government estimates more than half of Americans living with HIV will be over 50. Even in developing countries, more people with the AIDS virus are surviving to middle age and beyond.

That's good news - but it's also a challenge. There's growing evidence that people who have spent decades battling the virus may be aging prematurely.

At the International AIDS Conference this week, numerous studies are examining how heart disease, thinning bones, and other health problems typically seen in the senior years seem to hit many people with HIV when they are only in their 50s.

Some of the graying of AIDS comes from newly diagnosed older adults, a trend U.S. health officials say is small but slowly growing. Grandparents still have sex - and that's an age group missed by all those hip safe-sex messages aimed at the young.

"They let down their guard," says Kevin Fenton, director of the National Center for HIV/AIDS and other illnesses at the Centers for Disease Control and Prevention.

People 50 or older accounted for 17 percent of new U.S. HIV diagnoses in 2009, according to the CDC. That's up from 13 percent in 2001.

In hard-hit sub-Saharan Africa, home to most of the world's HIV-infected population, studies suggest three million people living with HIV are 50-plus, said Joel Negin of the University of Sydney.

Today, people who are diagnosed and treated early can expect a near-normal life span, Anthony Fauci, infectious-disease chief at the National Institutes of Health, told the Associated Press.

As they reach their 50's, 60's, and beyond, they are now getting chronic illnesses such as heart disease, diabetes, kidney disease, and osteoporosis - common ailments when anyone gets old. But studies suggest people with HIV may be at higher risk or get them earlier.

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