By Neila Samdani

HIV (Human Immunodeficiency Virus) attacks the body’s immune system, making it harder to fight infections and certain cancers. If untreated, HIV can progress to AIDS (Acquired Immunodeficiency Syndrome), a life-threatening condition where the immune system is severely weakened. Thanks to modern antiretroviral therapy (ART), most people with HIV can now suppress the virus, stay healthy, and prevent AIDS.

HIV and Older Adults: The Numbers

Thanks to effective HIV treatment, people are living much longer with the virus. In the U.S., more than half of people with diagnosed HIV are now age 50 or older (hiv.gov). Worldwide, about 39.9 million people live with HIV (who.int) – and UNAIDS estimates roughly 8.1 million of them are age 50+ (pmc.ncbi.nlm.nih.gov). In sub-Saharan Africa, about 10% of people with HIV are over 50 (nearly 4 million) (aidsvu.org). These trends reflect both aging survivors and new diagnoses among older adults.

Why Older Adults May Be at Risk

The main HIV risk factors are the same at any age: unprotected vaginal or anal sex and sharing needles (hivinfo.nih.gov). But age brings additional concerns. For instance, after menopause vaginal tissues can thin and tear more easily during sex. Older men may use erectile dysfunction drugs, potentially increasing sexual activity and exposure (iapac.org). People over 50 also often forgo condoms, since pregnancy is no longer a concern. Many older adults underestimate their personal HIV risk.

Signs, Symptoms and Diagnosis

Early HIV infection may cause mild flu-like symptoms (fever, rash, sore throat, swollen glands) or none at all. It can take years for more serious issues to appear. If HIV progresses without treatment, symptoms can include chronic fatigue, weight loss, prolonged diarrhea or fevers, swollen lymph nodes, and unusual infections or cancers. Because many of these signs look like normal aging or other illnesses, older adults often discover HIV late. For example, one CDC report found that about one-third of U.S. adults over 55 were already at AIDS stage when they were diagnosed.

Stigma, Ageism and Misconceptions

HIV still carries stigma, especially for older people. Many assume – incorrectly – that “HIV is a disease of younger people,” notes researcher Dr. Mark Brennan-Ing. This age bias can prevent open conversations. Doctors often do not discuss sexual health with patients over 50, and older individuals may feel embarrassed to ask for an HIV test. Common myths add to the problem. For example, you cannot contract HIV from casual contact like hugging, shaking hands, or sharing dishes.

Testing and Prevention

Everyone who is sexually active or at risk should get tested. CDC guidelines recommend at least one lifetime HIV test for all adults, and more frequent testing if you have risk factors. Testing is easy and confidential: clinics, community centers, and health departments offer tests, and FDA-approved home test kits are available too. If you are 50 or older and have never been tested (or haven’t been in a while), ask your doctor about it.

Prevention methods for older adults are the same as for anyone:

• Use condoms: Always use latex or polyurethane condoms during sex. Proper condom use greatly lowers HIV transmission risk.

• Know your partner: Talk openly before sex. Discuss HIV/STI testing histories with partners and consider limiting the number of partners.

• Regular testing: Get screened for HIV and other sexually transmitted infections at least once a year if you are sexually active or have risk factors. Early detection protects you and helps prevent spread.

• Clean needles: If you inject drugs, never share syringes or needles. Use new, sterile equipment every time.

• Consider PrEP: If you are HIV-negative but at high risk (for example, you have an HIV-positive partner or multiple partners), talk to your doctor about pre-exposure prophylaxis (PrEP). PrEP is a daily pill that can reduce the chance of getting HIV by about 99% when taken consistently.

For people with HIV, staying on treatment prevents transmission too. When ART keeps the virus undetectable, it cannot be passed to sexual partners – a concept summarized as “U=U” (Undetectable = Untransmittable).

Treatment and Living Well

If you test positive, start ART as soon as possible. HIV treatment is recommended for everyone with the virus, including older adults. With modern therapy, most people with HIV can stay healthy and live near-normal lifespans. “People with HIV who are diagnosed early… can keep the virus suppressed and live long, healthy lives,” notes HIV.gov. In fact, more than 90% of Americans aged 50+ with HIV are virally suppressed on treatment.

Aging with HIV can include extra health challenges. Studies show that heart disease, diabetes, bone loss, and cognitive changes are more common in older people with HIV than their HIV-negative peers. For example, one study found that 6 out of 10 people over 65 with HIV had at least one disabling condition like heart disease or diabetes (cdc.gov). Polypharmacy – taking multiple medications – is also common as patients manage HIV alongside other conditions. Coordinated, whole-person care – addressing both medical and psychosocial needs – is recommended to help older patients thrive.

Why Awareness Matters for 50+

HIV doesn’t stop at age 50. Experts point out that many older adults are overlooked in prevention efforts. For instance, Dr. Brennan-Ing reports that “almost 20% of new infections are occurring in people over the age of 50”. Yet older people often receive little information about HIV risk or safer sex. Public health campaigns (like National HIV/AIDS and Aging Awareness Day) and updated guidelines now focus on encouraging testing and treatment for older adults too.

Awareness saves lives. By talking openly about sex and HIV at older ages, we break down stigma and encourage testing. If you’re over 50 and sexually active (or have other risk factors), remember: you can still get HIV, but you can also protect yourself and live well. With knowledge, respect, and medical care, HIV can be managed – and its spread prevented – at any age.