June 07, 2001 (The Boston Globe) - Evey Richardson is a grandmother
who used to think AIDS was for other people.
``When we were going together, I always used condoms,'' she said
of her second husband, Edner Fleurinor, who died seven years ago.
``But when we got married I felt, well, husband and wife, I didn't
think he could've had the virus.''
Richardson was infected by Fleurinor, who succumbed to the
disease. Now the Boston grandmother is spreading the word: Older
people must be as HIV aware as younger people.
Infection rates are growing rapidly among older Americans, but
because doctors often don't associate AIDS and seniors, cases of
HIV infection often are not diagnosed until the disease has
progressed to AIDS.
``It took about six years to figure out what I had because I had
diabetes, and some of the symptoms are the same,'' said Richardson,
56, who had a monogamous relationship with Fleurinor. ``The doctor
never asked me about my sex life when I was married or after I got
divorced. In fact, I've never had a doctor ask me about my sex
life. My husband was infected four years before we met. He never
told me.''
Twelve hundred miles to the south, in the senior haven of
Deerfield Beach, Fla., 70 older men and women gathered at a senior
center last month were asked to raise their hands if a doctor had
ever asked if they were sexually active. No hands were raised.
That is the reason Sue Saunders, a 69-year-old grandmother
living with AIDS, began speaking out for the Senior HIV
Intervention Project, which attempts to educate older people in
South Florida about the disease. When Saunders began experiencing
chronic fever, sore throat and rashes 12 years ago, she sought
medical help. Doctors at first diagnosed a thyroid problem. She was
finally tested for HIV two years later.
She has since found out that misdiagnosis happens all the time.
``A lot of these doctors see these women like their mothers. The
idea of wrinkled people having sex just throws them for a loop,''
says Saunders. ``They can't imagine it. They think we are dead from
the neck down.''
According to the Centers for Disease Control, the incidence of
AIDS has been growing twice as fast among people 50 and older as
among those under 50. Although nationally seniors aged 50 and older
account for only 13.4 percent of all reported AIDS cases, that
number has been rising for the past six years. Specialists say
those figures are probably conservative because of a lack of AIDS
testing of seniors.
``In the last 10 years, there has been a tenfold increase in the
numbers of persons diagnosed at 65-plus with AIDS,'' according to a
report by Marcia Ory of the National Institute on Aging and Karin
Mack of the CDC. The report said about 10,000 people 65 and older
had AIDS.
``Those numbers are relatively small, but to ignore small
numbers is tragic,'' Ory said in a telephone interview. ``Remember,
in 1981-82 people weren't really aware of what was happening in the
gay, white community.''
People infected in their 30s and 40s are also living longer with
the disease thanks to ``cocktails'' of antiviral drugs, and AIDS
deaths have been declining since 1996, according to the CDC. About
80,000 people 50 and older have been diagnosed with the disease so
far.
The agency does not keep national HIV statistics. It can take 10
years or longer to develop AIDS after contracting HIV.
Several factors are contributing to the increase in AIDS among
the elderly, specialists say.
``With the popular use of Viagra, more seniors are sexually
active,'' said Donna Gallagher, director of the New England AIDS
Education and Training Center. ``But several studies conclude older
Americans don't use condoms. We've approached Pfizer about
including information about safe sex, and they haven't done
anything yet. We're still hounding them.''
In South Florida, public health workers have noticed a new
phenomenon: elderly men cruising for prostitutes.
``It's true. They do that pretty much the first to the fifth of
each month when their Social Security checks and pensions come
in,'' said Gloria Scott, who works for the Florida Department of
Health.
``Viagra has played a big role. It's why there's more out there.
And the men don't like to use condoms,'' she said.
Although the virus is spread mostly through homosexual contact,
young gays buoyed by the success of the AIDS cocktail are still
taking risks selling sex to older men who don't use protection,
Scott said.
Intravenous infection is also a problem among seniors, partly
because of aging baby boomers still doing drugs, but also because
of diabetics sharing insulin needles.
For five years, Saunders traveled South Florida giving speeches
about AIDS and seniors until she fell ill and her weight plummeted
to 96 pounds. Saunders, who was involved for 20 years with ``the
love of my life'' in what she thought was a monogamous
relationship, was exposed to the disease by him in 1989.
``It never ever even dawned on me that I might be exposed,'' she
said. ``No way. Never even thought about it. Safe sex. Oh, you
never even think about that. It just never occurred to me.''
She said that there has been little research on senior citizens
and AIDS and that seniors face more complications because they are
taking other medications.
``I was just skin and bones and I wanted to die,'' she said.
She has since rallied and continues to speak out.
``Now I tell physicians to put `Are you sexually active? Have
you ever been tested for HIV?' on the first page of their
questionnaire.''
Marilyn Brand is a spunky 72-year-old HIV/AIDS health educator
who is called the ``Dr. Ruth of Palm Beach County.'' She recently
gave a talk to single seniors over coffee and Danish at the Jewish
Community Center in Boynton Beach, Fla. At one point in her talk,
she held a sign that read, ``Women want affection, not just
erection.'' The AIDS rate for seniors over 50 in Palm Beach County
is 16 percent of all reported cases.
As the seniors listened attentively, Brand told a cautionary
tale: ``They had a whorehouse across the street from Century
Village,'' a huge retirement community in West Palm Beach. ``A man
went over there and had relations with a prostitute, didn't use a
condom, and then came back and infected his wife. They both died.''
Brand had brought props to her talk: female condoms, dental dams
for oral sex, and OraSure, a toothbrush-like test to the gums for
HIV that does not require a needle or a blood test and is both
confidential and free in Florida.
``You go to the Health Department, they give you a toothbrush,
swish it around your gums, and in three days you get the
confidential results,'' she said.
An elderly man raised his hand. ``At what point in the
relationship do you give her a toothbrush?'' he asked.
Brand said that in some retirement communities the ratio of
women to men is 7-1.
``The women like to go out and dance and go to dinner and a
movie. If you are a man that can drive at night, you can have a
smorgasbord of women. And a lot of women are having facelifts and
getting gigolos.
``My biggest surprise is how innocent and naive the senior
citizen population is,'' said Brand. ``They don't realize that
protection is the way they can avoid the HIV virus. They think that
if they can't become pregnant, they don't need devices. And then
they get tested for everything but HIV.''
Lisa Agate, HIV/AIDS program director for the Broward County,
Fla., Health Department said things need to change. ``I think it's
a health-care emergency for health-care professionals to wake up.''
Doctors, she said, ``don't take full sexual histories, and you
can't just write them off as an aging issue.''
Because they have a lot of free time, Agate said, seniors are
more sexually active than most people think.
``The nursing home staff say, `You wouldn't believe how many
times we have to pull people out of their rooms. They're in their
rooms having sex.' It's a very big issue nursing home staffs have
to deal with.''
Data on sex among seniors are spotty, Agate said. Few surveys
have been done. But from what she and other public health workers
have witnessed she is ``certain the numbers have gone up.''
Richardson, a grandmother of five, has joined New England AIDS
Education, a Brookline, Mass., nonprofit advocacy group.
``I talk to my girlfriends till I'm blue in the face about using
condoms,'' she said. ``I say, `See me. I got that through my
husband.'
``What I am angry about is I didn't have a chance to make a
decision about safe sex. That grim reaping son of a gun had the
virus for four years before he met me. I asked him about it, and he
said, `You're not gonna die, you just get sick once in a while.'''
Now, said Richardson, she is determined that her friends
practice safe sex.
``I need to depend on you so that when I kick off you can make
sure my hair's done right, my nails are done right,'' she tells
them. ``I want balloons. I don't want anybody wearing dark
clothes.''
