Why Believing “Old Age Means No Intimacy” Endangers Elderly Health.

Longer life expectancy, improved living standards, lower mortality rates, and declining birth rates… people are getting older, and the elderly population is growing. Population aging is a well-worn topic. However, at the same time, a growing group is often overlooked— elderly people living with HIV/AIDS .

Statistics from the Chinese Center for Disease Control and Prevention show that the number of HIV-infected people aged 60 and above is increasing year by year , with sexual transmission being the main route of infection. The main reason is that many elderly people lack awareness of safe sex practices .

The elderly, AIDS, and sexually transmitted diseases are all old problems, but when combined, they form a new problem that is increasingly in need of attention.

The number of elderly people with HIV/AIDS is increasing.

Currently, the HIV/AIDS epidemic in my country is at a low prevalence level, but the absolute number of infected individuals is enormous. At the same time, the number of newly reported infections is on the rise each year, with the increase being particularly significant among HIV/AIDS patients aged 60 and above.

According to reports, China reported 5,943 new HIV/AIDS cases aged 60 and above in 2010, and 31,541 cases in 2018, with the proportion rising from 9.3% to 21.2%. HIV infection among the elderly is predominantly male . Among men aged 60 and above, the number of reported cases increased from 8,391 in 2012 to 24,465 in 2018.

The number of elderly people living with HIV/AIDS is steadily increasing, including both previously infected individuals who have aged and newly infected or diagnosed cases. With advancements in medical care, HIV/AIDS patients receiving antiretroviral therapy can lead normal lives, leading many to enter old age. However, statistical reports indicate that the increase in elderly HIV-infected individuals in recent years is primarily due to the rise in newly reported cases.

The increasing number of elderly HIV/AIDS patients is actually a global public health issue, and many countries and regions besides China are facing the same problem .

Being old ≠ having a condom

Age is not a condom

The number of elderly people infected with HIV has increased significantly, regardless of whether they are men or women. Moreover, the main cause of infection is sexual transmission. However, the ways in which the two sexes are infected are somewhat different.

Previous statistics from the Hangzhou Center for Disease Control and Prevention found that elderly men primarily contracted HIV through extramarital heterosexual contact , with some also contracting it through male-to-male sexual activity; while elderly women primarily contracted HIV through marital sexual activity . Epidemiological investigations in Zhejiang Province revealed that over two-thirds of elderly male cases were infected through commercial sex. Commercial sex without effective protection carries a very high risk of HIV infection.

Condoms are the first line of defense against HIV/AIDS; however, older adults use them less frequently during sexual activity compared to younger people . Postmenopausal women, not needing to worry about contraception , often don’t prioritize condom use. A study in Chicago found that 60% of single women over 60 (unmarried, divorced, or widowed) did not use condoms during sexual intercourse.

Furthermore, testosterone levels decline in men during aging. Older men also frequently experience problems such as benign prostatic hyperplasia (BPH), requiring treatments such as prostatectomy. Therefore, older men are more likely to experience sexual dysfunction and erectile dysfunction, making it more difficult to ensure the effective use of condoms .

Regardless of age, anyone who does not use a condom or does not use it correctly can contract HIV. The virus affects people of all ages equally, but older adults are actually more susceptible .

As people age, their immune system weakens. Menopause in women causes a sharp drop in estrogen levels, leading to thinning and dryness of the vaginal walls, making them more susceptible to injury during intercourse. Therefore, older women have a higher risk of contracting HIV.

Elderly people with HIV/AIDS who are easily overlooked

In addition to the rapid increase in the number of people with HIV/AIDS, the problem of elderly people with HIV/AIDS is also characterized by being easily overlooked and difficult to diagnose .

The increasing number of newly reported HIV infections among the elderly each year also means that more elderly people are getting tested for HIV, but compared to younger people, the elderly are still getting tested less often . Furthermore, many elderly people are already in the late stages of HIV infection when diagnosed, so they start treatment later, their immune systems may be more severely damaged, and they suffer greater physical pain.

Early detection allows for early treatment, and the earlier the treatment, the better the outcome. However, many factors in reality affect older adults’ willingness to undergo testing:

The elderly themselves lack sufficient understanding of HIV/AIDS prevention and control;

The symptoms of AIDS in the elderly may be mistaken for aging or other age-related diseases . For example, AIDS patients may experience symptoms such as forgetfulness and memory loss (HIV-associated Dementia, HAD), which can easily be misdiagnosed as Alzheimer’s disease.

Many medical professionals also did not think of testing the elderly;

…

This is why, at this very moment, many elderly people with HIV/AIDS are unaware that they are infected or are receiving treatment for other diseases.

Change outdated sexual concepts

HIV/AIDS prevention and control among the elderly is an important and complex public health issue that requires the efforts of all parties. Whether young or old, we can all start by changing our own attitudes and acknowledging the sexual needs of the elderly . Sexual activity among the elderly is not shameful; what is shameful is outdated prejudice.

Sex is not just for young people; it’s an integral part of life. Aging and chronic diseases can affect the libido and sexual function of older adults. While many elderly people are indeed afraid to talk about sex and lead sexless lives, there are also many elderly people who are sexually fulfilled or actively seeking sexual happiness.

“ Even among the 71-75-year-olds, nearly half continue to engage in sexual activity ,” sexologist Kinsey stated in his famous Kinsey Reports. Professor Pan Suiming, hailed as “China’s leading sexologist,” also said: “ The sex lives of the elderly are actually incredibly rich , and they have transcended the narrow-minded view of ‘only penetration’ that is common among young people.”

Safe and enjoyable sex life has many benefits: it can boost immunity, burn calories, lower blood pressure, relax people, and may even reduce the risk of prostate cancer in men. Harmonious intimacy can also promote affection between older couples and prolong life.

In October 2019, the National Health Commission and other departments jointly formulated the “Implementation Plan for Curbing the Spread of AIDS (2019-2022),” which clearly pointed out that it is necessary to ” strengthen publicity and education for the elderly ” so that the awareness rate of AIDS prevention and control knowledge among the elderly can reach more than 90%.

It is hoped that in the future, the elderly will benefit from these messages, understand HIV/AIDS prevention and control, and enjoy a sexually fulfilling later life in a safe and healthy environment. It is also hoped that elderly people with HIV/AIDS will not be ignored or discriminated against, thus encouraging more elderly people living with HIV/AIDS to have the courage to receive timely diagnosis and treatment.

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Why Believing “Old Age Means No Intimacy” Endangers Elderly Health.